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行胆囊切除术而不做肝切除术治疗早期偶发胆囊腹膜侧癌。

Radical cholecystectomy without liver resection for peritoneal side early incidental gallbladder cancer.

机构信息

Department of Health Sciences (DISS), University of Milan, San Paolo Hospital, Milan 20142, Lombardy, Italy.

Department of Colorectal Surgery, Portsmouth Hospitals University NHS Trust, Portsmouth, United Kingdom.

出版信息

World J Gastroenterol. 2024 Aug 28;30(32):3739-3742. doi: 10.3748/wjg.v30.i32.3739.

Abstract

Gallbladder cancer (GBC) is a rare disease with a poor prognosis. Simple cholecystectomy may be an adequate treatment only for very early disease (Tis, T1a), whereas reoperation is recommended for more advanced disease (T1b and T2). Radical cholecystectomy should have two fundamental objectives: To radically resect the liver parenchyma and to achieve adequate clearance of the lymph nodes. However, recent studies have shown that compared with lymph node dissection alone, liver resection does not improve survival outcomes. The oncological roles of lymphadenectomy and liver resection is distinct. Therefore, for patients with incidental GBC without liver invasion, hepatic resection is not always mandatory.

摘要

胆囊癌(GBC)是一种预后较差的罕见疾病。单纯胆囊切除术可能仅适用于非常早期的疾病(Tis、T1a),而对于更晚期的疾病(T1b 和 T2)则推荐再次手术。根治性胆囊切除术应有两个基本目标:彻底切除肝实质和充分清除淋巴结。然而,最近的研究表明,与单独淋巴结清扫相比,肝切除术并不能改善生存结果。淋巴结清扫和肝切除术的肿瘤学作用是不同的。因此,对于无肝侵犯的偶然胆囊癌患者,肝切除术并非总是必需的。

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Surgical Strategy for T2 Gallbladder Cancer According to Tumor Location.根据肿瘤位置制定的T2期胆囊癌手术策略
Ann Surg Oncol. 2015 Aug;22(8):2779-86. doi: 10.1245/s10434-014-4300-7. Epub 2014 Dec 18.

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