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腹腔镜胆囊切除术中偶然发现的胆囊癌:如何处理。

Gallbladder carcinoma incidentally encountered during laparoscopic cholecystectomy: how to deal with it.

机构信息

Department of Surgical Oncology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.

出版信息

Clin Transl Oncol. 2011 Jan;13(1):25-33. doi: 10.1007/s12094-011-0613-1.

Abstract

Gallbladder cancer (GBC), characterised by rapid progression and a poor prognosis with a high mortality rate, is a complex disease to treat. Incidental gallbladder carcinoma (IGBC) is defined as carcinoma of the gallbladder suspected for the first time during cholecystectomy or accidentally found on histological examination of the gallbladder. With the increasingly widespread acceptance of laparoscopic cholecystectomy (LC) and difficulties in diagnosing GBC preoperatively, the number of cases of IGBC during and after LC has increased. However, management of IGBC is a difficult issue in the absence of established guidelines. Problems associated with IGBC related to LC are the decisions of whether, when and how to perform additional surgery. Controversy remains regarding the effectiveness of additional resection in different stages of GBC. This review gives an overview of IGBC related to LC, and further discusses the preoperative, intraoperative and postoperative diagnosis and management of IGBC during LC.

摘要

胆囊癌(GBC)具有进展迅速、预后不良和死亡率高的特点,是一种难以治疗的复杂疾病。偶然发现的胆囊癌(IGBC)是指在胆囊切除术过程中首次怀疑或偶然在胆囊组织学检查中发现的胆囊癌。随着腹腔镜胆囊切除术(LC)的广泛接受以及术前难以诊断 GBC,LC 期间和之后 IGBC 的数量有所增加。然而,由于缺乏既定的指南,IGBC 的管理是一个难题。与 LC 相关的 IGBC 相关问题是是否、何时以及如何进行额外手术的决策。在不同阶段的 GBC 中,附加切除的有效性仍存在争议。本综述概述了与 LC 相关的 IGBC,并进一步讨论了 LC 期间 IGBC 的术前、术中及术后诊断和治疗。

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