胆囊癌扩大肝切除术
Extended hepatic resection for gallbladder cancer.
作者信息
Reddy Srinevas K, Marroquin Carlos E, Kuo Paul C, Pappas Theodore N, Clary Bryan M
机构信息
Division of General Surgery, Department of Surgery, Duke University Medical Center, Box 3247, Durham, NC 27710, USA.
出版信息
Am J Surg. 2007 Sep;194(3):355-61. doi: 10.1016/j.amjsurg.2007.02.013.
BACKGROUND
Although radical cholecystectomy is the standard of care for gallbladder cancers that invade perimuscular connective tissue or perforate visceral peritoneum, the role of extended right hepatectomy in achieving negative resection margins is not clear.
METHODS
Clinicopathologic, perioperative, and long-term outcome data were reviewed from patients who underwent hepatic resection for gallbladder cancer.
RESULTS
From 1995 to 2005, 22 consecutive patients underwent hepatic resection for gallbladder cancer, and 11 underwent extended hepatectomy. Negative resection margins were achieved in all patients. There were no significant differences in postoperative morbidity, mortality, and long-term survival after extended and minor hepatectomy. T3 tumors negatively predicted overall and recurrence-free survival.
COMMENTS
Extended hepatectomy achieves negative resection margins for patients with gallbladder cancer and is associated with acceptable morbidity and long-term survival.
背景
尽管根治性胆囊切除术是治疗侵犯肌周结缔组织或穿透脏腹膜的胆囊癌的标准治疗方法，但扩大右肝切除术在实现阴性切缘方面的作用尚不清楚。
方法
回顾了接受胆囊癌肝切除术患者的临床病理、围手术期和长期结局数据。
结果
1995年至2005年，连续22例患者接受了胆囊癌肝切除术，其中11例接受了扩大肝切除术。所有患者均实现了阴性切缘。扩大肝切除术和小范围肝切除术后的术后发病率、死亡率和长期生存率无显著差异。T3肿瘤对总生存期和无复发生存期有负面预测作用。
评论
扩大肝切除术可使胆囊癌患者获得阴性切缘，且发病率可接受，长期生存率良好。
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