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原发性胆囊癌是一种少见的恶性肿瘤,约占恶性肿瘤的0.3％～6％。我院自1984年以来,共收治38例,现报告如下。 1 临床资料 1.1 一般情况 男10例,女28例;年龄40～80岁(50～70岁者26例,占68.4％),平均62岁。右上腹痛者24例,黄疸18例,发热8例,右上腹肿块9例,有乏力、消瘦、体重减轻者6例,呕吐4例。病程多为1年内,部分合并胆囊结石的患者上腹痛时间较长,甚至有26年者。其中有20例合并胆囊结石。 1.2 术前诊断 胆囊癌8例,结石性胆囊炎21例,肝癌4例,阻塞性黄疸3例,胆管癌2例。术前确诊率仅为21.1％。 1.3 病理分期 按Nevin分期,Ⅰ～Ⅱ期6例,Ⅲ～Ⅳ期12例,Ⅴ期20例。 1.4 治疗 本组38例均行手术治疗,术中所见:有14例胆囊明显增大,胆囊壁明显增厚、坚韧,8例含胶冻样组织,7例含白色胆汁,10例肿瘤沿胆囊管浸润至胆总管,有5例胆囊管完全闭塞,9例肿瘤沿胆囊床向肝组织浸润,5例伴有腹水,3例肿瘤与横结
Primary gallbladder carcinoma is a rare malignant tumor that accounts for about 0.3% to 6% of malignant tumors. In our hospital, 38 cases have been treated since 1984. The report is as follows. 1 Clinical data 1.1 The general situation of 10 males and 28 females; aged 40 to 80 years (50 to 70 years old 26 cases, accounting for 68.4%), an average of 62 years old. There were 24 cases of right upper abdominal pain, 18 cases of jaundice, 8 cases of fever, 9 cases of right upper abdominal mass, 6 cases of fatigue, weight loss, weight loss, and 4 cases of vomiting. Most of the patients had a course of 1 year. Some patients with gallstones had a long upper abdominal pain, even for 26 years. Among them, 20 patients had gallstones. 1.2 preoperative diagnosis of gallbladder cancer in 8 cases, 21 cases of stone cholecystitis, 4 cases of liver cancer, obstructive jaundice in 3 cases, 2 cases of cholangiocarcinoma. The preoperative diagnosis rate was only 21.1%. 1.3 Pathological staging Nevin stage, I ~ II in 6 cases, III ~ IV in 12 cases, V in 20 cases. 1.4 Treatment 38 patients in this group underwent surgical treatment. Seen during operation: There were 14 cases of gallbladder enlargement, gallbladder wall thickening and toughness, 8 cases contained jelly-like tissue, 7 cases contained white bile, and 10 cases of tumor along Infiltration of the cystic duct into the common bile duct, 5 cases of complete cystic duct occlusion, 9 cases of tumor along the gallbladder bed infiltration of liver tissue, 5 cases with ascites, 3 cases of tumor and lateral junction