al-Hadeedi S Y, Moorehead R J, Leaper D J, Wong J
Department of Surgery, University of Hong Kong, Queen Mary Hospital.
J R Coll Surg Edinb. 1991 Jun;36(3):174-7.
Since the introduction and availability of abdominal ultrasound and computed tomography, 38 patients have been admitted to the Department of Surgery, Queen Mary Hospital, University of Hong Kong with a subsequently confirmed histological diagnosis of carcinoma of the gallbladder. The majority of patients presented with abdominal pain, anorexia or weight loss, jaundice, and anaemia or an abdominal swelling. Abnormal liver function tests were found in 70-90%. Cholangiography, ultrasound and particularly computed tomography helped to confirm clinical suspicion when performed but 23 patients (61%) had an inaccurate diagnosis made before surgery. Operative intervention was only of benefit when the carcinoma was confined to the gallbladder (median survival after cholecystectomy alone 13 months; other procedures 2 months; P less than 0.01). Carcinoma of the gallbladder carries a poor prognosis but ultrasound and computed tomography can help select patients for appropriate treatment (surgery, endoscopic stenting, radiotherapy, chemotherapy) if clinical suspicion is raised.
自从腹部超声和计算机断层扫描技术问世并可应用以来，香港大学玛丽医院外科收治了38例随后经组织学确诊为胆囊癌的患者。大多数患者表现为腹痛、厌食或体重减轻、黄疸、贫血或腹部肿块。70% - 90%的患者肝功能检查异常。胆管造影、超声尤其是计算机断层扫描在进行检查时有助于证实临床怀疑，但23例患者（61%）在手术前诊断不准确。仅当癌局限于胆囊时手术干预才有益（单纯胆囊切除术后中位生存期13个月；其他手术为2个月；P<0.01）。胆囊癌预后较差，但如果临床产生怀疑，超声和计算机断层扫描有助于选择合适的治疗方法（手术、内镜支架置入、放疗、化疗）。
