原发性胆囊癌
安东均
摘 要
目的：探讨胆囊癌的早期诊断及各种手术对其预后的影响。
方法：对56例胆囊癌患者的致病因素进行分析。
结果：按照Nevin分期Ⅰ期5例，Ⅱ期7例，Ⅲ期10例，Ⅳ期13例，Ⅴ期10例。行各类切除性手术32例（57.1%），剖腹探查取活检13例（23.2%），非手术行放疗或化疗11例（19.7%）。各类切除性手术的1年、3年、5年生存率分别为56.3%（18/32），28.1%（9/32），12.5%（4/32），探查活检的 13 例及非手术治疗的11例均在明确诊断后5个月内死亡。
结论：早期诊断和及时行根治性手术是改善胆囊癌预后的关键。
关键词
胆囊肿瘤；腺癌
Primary gallbladder carcinoma
An Dongjun
Department of Hepatobiliary Surgery，The Second People's Hospital of Xianyang City，Xianyang，Shanxi 712000
ABSTRACT
Objective:To evaluate the effects of the early diagnosis and surgical therapy on the prognosis of primary gallbladder carcinoma（PGC）.
Methods:The pathogeneses of 60 patients with PGC was analysed retrospectively.
Results:According to the Nevin's classification:5 cases belonged to stage Ⅰ，7 cases stage Ⅱ，10 cases stage Ⅲ，13 cases stage Ⅳ and 10 cases stage Ⅴ.Thirty-two cases（57.1% ）underwent tumor resection，13 cases（23.2% ）were subjected to laparotomy and biopsy，11 cases（19.7% ）were treated with radiotherapy or chemotherapy.The 1-，2-，5-years surviving rate of PGC after resective operation were 56.3%（18/32），28.1%（9/32），12.5%（4/32）respectively.All cases who underwent biopsy or nonoperative died within five months after the diagnosis was made.
Conclusion:Early diagnosis and prompt radical resection are the main points for improving the prognosis of patients with PGC.
SUBJECT WORDS
gallbladder neoplasm；Adenocarcinoma
原发性胆囊癌临床上并非罕见，目前诊治上最突出的问题是早期诊断率低、术前误诊率高、治愈性手术切除率低，因而术后长期生存率低。原发性胆囊癌的早期诊断与治疗是目前胆道外科迫切要解决的问题。我院1982年以来收治原发性胆囊癌56例，本文就其早期诊断与治疗报告如下。