【摘要】 目的　探讨对中晚期胆囊癌积极进行外科治疗的价值。方法　对 34例中晚期胆囊癌 ,除行胆囊切除外 ,行肝段切除 7例、半肝切除 1例、肝门部胆管切除高位胆肠吻合 4例、肝段切除 +肝门部胆管切除高位胆肠吻合 6例、肝部分切除及胰头十二指肠切除 16例。其中同时行肝十二指肠韧带淋巴结骨骼化清扫 2 8例 ,行肾门淋巴结清扫 1例 ,行右半结肠切除 1例 ,行受累肝动脉切除2例。结果　手术均顺利完成 ,并发胆漏 6例 ,其中死于多器官功能衰竭 1例 ,经引流后愈合 5例 ;1例并发应激性溃疡出血。 12个月前手术者 17例 ,10例仍存活 ,其中 2例存活已超过 30个月 ,最长者达 48个月 ;17例 12个月内手术者 16例存活。结论　对中晚期胆囊癌积极进行手术治疗 ,能改善患者生活质量 ,延长生存期。更多还原

【Abstract】 Objective To evaluate the effect of surgical treatment on the survival of patients with advanced gallbladder carcinoma.Method 34 patients with advanced gallbladder carcinoma underwent in addition to cholecystectomy liver segmentectomy (7 cases), hemiheptectomy (one case), resection of hilar bile duct (4 cases), combined resection of hepatic segment with hilar bile duct (6 cases),and partial hepatectomy plus pancreatoduodectomy (HPD) in 16 cases. Skeletonized dessection of lymph node of hepatoduodenum ligament were performed in 28 cases.Results All the operations were carried out successfully. Of the 17 cases who received operations 12 months ago, 10 cases are still alive and 2 cases have lived more than 30 months,with the longest being 48 months. Of the remaining 17 cases undergoing surgery within the last 12 months, 16 cases are still alive.Conclusion Our result suggests that aggresive surgical management could help in prolonging the survival and improving the life quality of patients with advanced gallbladder carcinoma.更多还原