意外胆囊癌的外科治疗

The surgical management of incidental gallbladder carcinoma.

作者信息

Yildirim E, Celen O, Gulben K, Berberoglu U

机构信息

Department of Surgery, Ankara Oncology Teaching and Research Hospital, Ankara, Turkey.

出版信息

Eur J Surg Oncol. 2005 Feb;31(1):45-52. doi: 10.1016/j.ejso.2004.09.006.

DOI:10.1016/j.ejso.2004.09.006

PMID:15642425

Abstract

AIMS

To report the surgical management of carcinoma of the gallbladder.

METHODS

A retrospective study in 65 patients who underwent simple (SC) or extended (EC) cholecystectomy for gallbladder carcinoma.

RESULTS

28 patients underwent extended cholecystectomy (EC) and 37 had simple cholecystectomy (SC). The multivariate analysis showed that lymph-node status (positive vs negative, p=0.001, Hazard Ratio [HR]:14.2, 95% Confidence Interval [CI]:3.1-62.8) and type of surgery (SC vs EC, p=0.01, HR:10.2, 95% CI:1.7-62.8) were the most important prognostic factors related to death. This analysis indicated that EC in those with pT(2) or pT(3) was associated with a reduce hazard of death by 90% in the follow-up period.

CONCLUSIONS

In gallbladder cancer patients who diagnose after simple cholecystectomy, those with pT(1) with clear margins need no further surgery. In patients with pT(2) or pT(3) incidental carcinoma, the completion radical re-operation is the only chance for long-term survival.

摘要

目的

报告胆囊癌的外科治疗方法。

方法

对65例行单纯性（SC）或扩大性（EC）胆囊切除术治疗胆囊癌的患者进行回顾性研究。

结果

28例行扩大性胆囊切除术（EC），37例行单纯性胆囊切除术（SC）。多因素分析显示，淋巴结状态（阳性与阴性，p = 0.001，风险比[HR]：14.2，95%置信区间[CI]：3.1 - 62.8）和手术类型（SC与EC，p = 0.01，HR：10.2，95% CI：1.7 - 62.8）是与死亡相关的最重要预后因素。该分析表明，pT(2)或pT(3)患者行EC在随访期死亡风险降低90%。