【摘要】 目的　探讨胆囊癌早期诊治经验。方法　回顾性分析 1993～ 2 0 0 0年腹腔镜术中发现的 41例胆囊癌临床资料。结果　术中探查结合活检明确诊断 36例 (87 8% ) ,术后病理诊断 5例。Ⅰ期胆囊癌行腹腔镜胆囊切除术 (LC)者 ,3年生存率 10 0 % ;Ⅱ期胆囊癌行LC者 ,3年生存率 77 7% ,行根治术者 ,3年生存率 10 0 % ;Ⅲ期胆囊癌行根治术者 ,2年生存率 75 % ,3年生存率 5 0 % ;Ⅳ期胆囊癌行根治术者 ,2年生存率 33% ,3年生存率为 0 ;Ⅲ期胆囊癌 1例 ,仅行LC ,术后 5个月死于肝转移。 15例中转剖腹行根治术者 ,5例未切除套管孔 ,其中 1例切口种植。结论　现代腹腔镜技术可弥补影像学的不足。早期发现胆囊癌并对Ⅱ期以上胆囊癌行根治术 ,能提高术后生存率 ,效果优于仅行LC者 ,对LC中转剖腹手术者 ,应切除套管孔以防切口种植更多还原

【Abstract】 Objective To evaluate the early diagnosis and surgical treatment of gallbladder carcinoma.Methods A retrospective analysis was made on 41 cases of gallbladder carcinoma admitted from 1993 to 2000.Results 36(87 8%) cases were diagnosed during operating LC,5 cases were diagnosed by pathology.Long-term survival was achieved in cases of stage Ⅰ.3-year survival rate in cases of stage Ⅱ that received radical resection was higher than the other cases of stage Ⅱ that only received LC.One out of five cases that received immediate laparotomy for radical cholecystectomy without cutting away all stab wound for trocars was complicated with tumor planting.Conclusion More early gallbladder carcinoma can be diagnosed by laparoscopic.Early diagnosis and radical cholecystectomy are still the mainstay for long-term survival of the patients with gallbladder carcinoma.In all immediate laparotomy for radical cholecystectomy,all stab wound for trocars must be cut away.更多还原