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目的探讨无症状性胆囊结石与胆囊癌发生之间的关系及其手术时机。方法总结1982年1月至1999年12月手术切除胆囊结石4249例,合并胆囊癌23例的临床病理资料,以无症状性胆囊结石与症状性胆囊结石为两个研究单元,对比胆囊癌的发病情况及预后。结果无症状性胆囊结石组发现胆囊癌 Nevin Ⅰ、Ⅱ期18例,Ⅲ期1例,Ⅳ期2例。症状性胆囊结石组发现 Nevin Ⅲ期胆囊癌2例。手术后随访5年以上16例,5年生存率69.56％。结论重新评估无症状性胆囊结石的治疗策略,不应过分强调胆囊癌高危因素的存在,宜采取积极的手术治疗态度。
Objective To investigate the relationship between asymptomatic gallstone and gallbladder carcinoma and its timing. Methods From January 1982 to December 1999, 4249 cases of gallbladder stones and 23 cases of gallbladder carcinomas were analyzed retrospectively. Clinicopathological data of asymptomatic gallstones and symptomatic gallstones were compared with those of gallbladder carcinomas Situation and prognosis. Results In asymptomatic gallstone group, there were 18 cases of gallbladder carcinoma Nevin I, 1 case of stage Ⅲ and 2 cases of stage Ⅳ. Symptomatic gallstone group found Nevin Ⅲ gallbladder carcinoma in 2 cases. After the operation, 16 cases were followed up for more than 5 years, and the 5-year survival rate was 69.56%. Conclusion Reassessment of asymptomatic treatment of gallstones should not be overemphasized the existence of high risk factors for gallbladder cancer should adopt a positive attitude to surgical treatment.