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目的探讨胆囊癌与胆囊结石的关系及胆囊结石伴胆囊癌的诊断和治疗特点。方法对1993年1月至2004年12月间收治的27例胆囊癌合并胆囊结石患者进行回顾性临床分析。结果27例胆囊癌合并胆囊结石患者,男10例,女17例,男女之比为1:1.7。平均年龄68.5岁,其中60岁以上22例。临床症状最常见为腹痛(85.2%)。既往有明确胆结石病史患者15例,入院后发现胆结石的有12例。行B超检查的23例,诊断胆囊癌的有12例(52.2%)。CT结合增强扫描检查12例,诊断胆囊癌的有8例(66.7%)。行肿瘤根治切除者8例,根治率29.6%。随访13例,随访期为3个月~7年,获随访者的平均存活时间为12个月。结论胆囊结石是胆囊癌的发病因素之一,胆囊癌早期诊断困难,晚期治疗效果差,伴胆囊结石的胆囊癌关键是要引起重视,不能满足胆囊结石的诊断而遗漏胆囊癌。对胆囊结石患者要密切随访,高危患者要尽早手术。
Objective To investigate the relationship between gallbladder carcinoma and gallstone and the diagnosis and treatment of gallstone with gallbladder carcinoma. Methods Retrospective clinical analysis of 27 cases of gallbladder carcinoma with gallstone admitted from January 1993 to December 2004 were retrospectively analyzed. Results 27 cases of gallbladder cancer with gallstone disease, 10 males and 17 females, male to female ratio was 1: 1.7. The average age of 68.5 years, of which 22 cases over the age of 60. The most common clinical symptoms were abdominal pain (85.2%). Past history of patients with a clear history of gallstones in 15 cases, admitted to hospital found that 12 cases of gallstones. 23 cases were diagnosed by B ultrasound and 12 cases were diagnosed as gallbladder cancer (52.2%). CT combined with enhanced scan in 12 cases, diagnosis of gallbladder cancer in 8 cases (66.7%). Radical tumor resection in 8 cases, the cure rate was 29.6%. Follow-up of 13 cases, the follow-up period of 3 months to 7 years, the average survival time of follow-up was 12 months. Conclusions Gallstones are one of the risk factors for gallbladder cancer. Early diagnosis of gallbladder cancer is difficult. Late treatment is poor. Gallbladder gallbladder cancer is the key to pay attention to, can not meet the diagnosis of gallstone and omit gallbladder cancer. Close follow-up of patients with gallstone, high-risk patients to surgery as soon as possible.