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腹腔镜胆囊切除术中意外胆囊癌的处理对策
Clinical measures for diagnosis and treatment of unsuspected gallbladder carcinoma during laparoscopic cholecystectomy
【摘要】 目的 :探讨腹腔镜胆囊切除术 (LC)中有效诊治意外胆囊癌 (unsuspectedgallbladdercarcinoma ,UGC)的方法。方法 :回顾分析LC意外胆囊癌 6例的临床资料。结果 :单纯腹腔镜胆囊切除 2例 ,其中 1例T1 期随访 4年 ,至今存活 ;1例T3 期 ,3月后死亡。LC中转开腹T4期 1例 ,行根治术后 5个月死亡。LC术后二次手术者 3例 ,均为T3 期 ,其中 1例LC后腹腔并切口转移 (portsitemetastases ,PSM) ,姑息外引流术 6个月后死亡 ,余 2例行根治术后全部存活 ,其中 1例超过 2 5个月。结论 :早期警惕 ,术中无瘤操作 ,及时根治切除是延长UGC患者术后生存期及减少切口转移的关键
【Abstract】 Objective:To explore the diagnosis and treatment of unsuspected gallbladder carcinoma(UGC)during laparoscopic cholecystectomy(LC).Methods:The clinical data of 6 cases with UGC during LC was reviewed retrospectively.Results:LC was performed on 6 cases.One case with T 1,who was performed by LC alone four years ago,is alive to date.Of the 4 cases with T 3,two underwent a second radical operation,one of them had remained free of diseases for more than 25 months.One case underwent no additional procedures,died 3 months later.Palliative operation was adopted by another case,who was found abdominal implantation metastases including port site metastases(PSM) after LC and died 6 months later.The case with T 4 had an open radical operation to which the procedure was converted from LC died 5 months later.Conclusions:It is a key to be the vigilance to early gallbladder cancer and choice timely a second or converted open radical surgery for T 2 T 4.For the PSM and poor survival of the UGC,it is also important for practitioners to stick to the principles of non tumor manipulation when using laparoscopic technique.
【Key words】 Gallbladder neoplasms; Cholecystectomy,laparoscopy; Neoplasm metastases;
- 【文献出处】 腹腔镜外科杂志 ,Journal of Laparoscopic Surgery , 编辑部邮箱 ,2004年01期
- 【分类号】R657.4
- 【被引频次】8
- 【下载频次】93