论文部分内容阅读
目的 :探讨胆囊癌的手术治疗。方法 :5 2例胆囊癌按Nevin分期采用不同手术方法。NevinⅠ期 8例 ,4例行单纯胆囊切除术 ,4例行扩大的胆囊切除术 ;NevinⅡ、Ⅲ、Ⅳ期 19例 ,行扩大胆囊切除术 ;NevinⅤ期 2 5例 ,8例行超扩大胆囊切除术。结果 :随访 41例 ,各组 1、3、5年生存率 :Ⅰ期 8例 ,4例行单纯胆囊切除术 ,生存数分别为 4例、3例和 2例 ,4例行扩大的胆囊切除术均存活 ;Ⅱ、Ⅲ、Ⅳ期 17例 ,行扩大的胆囊切除术生存数分别为 12例、8例和 5例 ;Ⅴ期 8例行超扩大胆囊切除术生存数分别为 4例、3例和 1例 ,行剖腹活检或内外引流的 17例均在 10个月内死亡。结论 :Ⅰ期扩大胆囊切除优于单纯性胆囊切除术 ,Ⅱ、Ⅲ、Ⅳ期应采用扩大胆囊切除术 ,并注意清扫局部淋巴结 ,Ⅴ期在条件许可时采用超扩大胆囊切除术 ,可明显提高术后生存率
Objective: To investigate the surgical treatment of gallbladder cancer. METHODS: A total of 52 cases of gallbladder carcinoma were treated with different surgical methods according to the Nevin stage. 8 cases were Nevin I, 4 cases underwent simple cholecystectomy, 4 cases underwent extensive cholecystectomy; 19 cases underwent Nevin II, III, and IV stages and expanded cholecystectomy; 25 cases under NevinV stage; 8 cases underwent super-enlarged cholecystectomy Surgery. RESULTS: Forty-one patients were followed up for 1 year, 3 and 5 years survival rate in each group: 8 patients in stage I, 4 patients underwent simple cholecystectomy, 4 patients survived, 3 patients and 2 patients respectively, 4 patients underwent extensive cholecystectomy. All patients survived; in 17 patients with stage II, III, and IV, the number of patients undergoing extensive cholecystectomy was 12 cases, 8 cases, and 5 cases; the survival rate of 8 patients undergoing super-enlarged cholecystectomy in V stage was 4 and 3 respectively. In both cases and 1 case, 17 cases undergoing laparotomy or internal and external drainage all died within 10 months. Conclusion: Stage I enlarging cholecystectomy is superior to simple cholecystectomy. Stages II, III, and IV should be performed with enlarged cholecystectomy, and attention should be paid to the removal of regional lymph nodes. V-stage ultra-expanding cholecystectomy can be significantly improved when conditions permit. Postoperative survival rate