Wakasa Yusuke, Toyoki Yoshikazu, Kusumi Tomomi, Kameyama Yuma, Odagiri Tadashi, Jin Hiroyuki, Nakai Makoto, Aoki Kazunori, Kawashima Hiroaki, Endo Masaaki
Department of General Surgery, Aomori City Hospital, 1-14-20, Katta, Aomori, 030-0821, Japan.
Department of Pathology, Aomori City Hospital, Aomori, Japan.
Surg Case Rep. 2022 Mar 25;8(1):50. doi: 10.1186/s40792-022-01406-9.
Conversion surgery, which is defined as chemotherapy or chemoradiotherapy followed by radical surgery, may improve survival of patients with initially unresectable advanced biliary tract cancer, including gallbladder cancer. However, there are few reports on conversion surgery for advanced gallbladder cancer.
A 69-year-old woman was referred to our hospital with initially unresectable gallbladder cancer with peritoneal carcinomatosis. She underwent gemcitabine plus cisplatin therapy for 9 months. Extended cholecystectomy, resection of the extrahepatic bile duct with regional lymph node dissection, and total omentectomy were then performed as conversion surgery. The patient has survived without recurrence for 19 months postoperatively (31 months after the initial diagnosis) while continuing chemotherapy.
This case suggests that conversion surgery for advanced gallbladder cancer is effective and may be curative for locally advanced disease and distant metastasis such as peritoneal carcinomatosis.
转化手术定义为化疗或放化疗后行根治性手术，其可能改善包括胆囊癌在内的初始不可切除的晚期胆管癌患者的生存率。然而，关于晚期胆囊癌转化手术的报道较少。
一名69岁女性因初始不可切除的伴有腹膜癌转移的胆囊癌转诊至我院。她接受了9个月的吉西他滨联合顺铂治疗。随后行扩大胆囊切除术、肝外胆管切除及区域淋巴结清扫术和全网膜切除术作为转化手术。患者术后存活19个月无复发（初始诊断后31个月），同时继续化疗。
该病例提示晚期胆囊癌转化手术是有效的，对于局部晚期疾病及远处转移如腹膜癌转移可能具有治愈性。
