Jones R S
Department of Surgery, University of Virginia Health Sciences Center, Charlottesville 22908.
World J Surg. 1991 May-Jun;15(3):348-51. doi: 10.1007/BF01658727.
Gallbladder cancer afflicts predominantly women, the elderly, and persons with gallstones. Despite its producing symptoms of abdominal pain, nausea and vomiting, weight loss, jaundice, and anorexia, this disease remains difficult to detect. Even with contemporary imaging techniques, most gallbladder cancers escape diagnosis until the time of laparotomy. The aggressive character of this malignancy permits an overall 5-year survival rate of 3-5%. Although cures occur, the majority of operations performed for gallbladder cancer are for palliation. The objects of palliation include relief of pain, relief of jaundice, relief of intestinal obstruction, and the restoration of normal food intake. Resection of the tumor should be performed whenever possible; however, extensive operations including large liver resections and pancreaticoduodenectomy should be avoided in the presence of distant metastases. In the presence of large unresectable hilar masses, internal biliary bypass may relieve jaundice. Biliary-enteric anastomosis using the segment III duct exposed via the umbilical fissure may offer satisfactory relief of jaundice in selected cases.
胆囊癌主要影响女性、老年人和患有胆结石的人。尽管它会产生腹痛、恶心、呕吐、体重减轻、黄疸和厌食等症状，但这种疾病仍然难以检测。即使使用现代成像技术，大多数胆囊癌在剖腹手术时才得以确诊。这种恶性肿瘤的侵袭性使得总体5年生存率为3%至5%。虽然有治愈的情况，但大多数为胆囊癌进行的手术都是为了缓解症状。缓解症状的目的包括减轻疼痛、缓解黄疸、解除肠梗阻以及恢复正常饮食。只要有可能，就应进行肿瘤切除；然而，在存在远处转移的情况下，应避免进行包括大范围肝切除和胰十二指肠切除术在内的广泛手术。在存在无法切除的大型肝门肿块时，内胆管旁路术可能会缓解黄疸。在某些病例中，通过脐裂暴露的Ⅲ段胆管进行胆肠吻合术可能会令人满意地缓解黄疸。
