Oertli D, Herzog U, Tondelli P
Department of Surgery, St. Claraspital, Basel, Switzerland.
Eur J Surg. 1993 Aug;159(8):415-20.
To evaluate the results of operations for primary carcinoma of the gallbladder during the 16 year period 1975-1990.
Retrospective study.
University affiliated hospital in Switzerland.
55 consecutive patients with primary carcinoma of the gallbladder.
Resection with curative and palliative intent was done in 34 (62%) and in 10 (18%), respectively. Thirty nine (62%) had simple cholecystectomy and two (4%) radical resections; the remaining 14 (25%) had palliative operations.
23 Patients (42%) had early tumours (confined to the gallbladder wall, TNM stages I and II), and 32 (58%) had late tumours (TMN stages III and IV). A tumour of the gallbladder was suspected from preoperative ultrasonography in 20 of 37 examined patients (54%); 17 (31%) had occult lesions. Five patients died during the 30 day postoperative period (9%), and the overall median survival was 8.6 months. One and five year survival rates were 40% and 7%, respectively. Only four patients had long term cures after cholecystectomy alone.
There was a high incidence of locoregional recurrence among patients with stage II disease, and this group benefit from more radical resections. For advanced tumours, palliation alone is preferable.
评估1975年至1990年这16年间原发性胆囊癌的手术结果。
回顾性研究。
瑞士的大学附属医院。
55例连续性原发性胆囊癌患者。
分别对34例（62%）患者进行了根治性切除，对10例（18%）患者进行了姑息性切除。39例（62%）患者接受了单纯胆囊切除术，2例（4%）患者接受了根治性切除；其余14例（25%）患者接受了姑息性手术。
23例（42%）患者为早期肿瘤（局限于胆囊壁，TNM分期为I期和II期），32例（58%）患者为晚期肿瘤（TMN分期为III期和IV期）。在37例接受检查的患者中，20例（54%）术前超声检查怀疑有胆囊肿瘤；17例（31%）有隐匿性病变。5例患者在术后30天内死亡（9%），总体中位生存期为8.6个月。1年和5年生存率分别为40%和7%。仅4例患者单纯胆囊切除术后获得长期治愈。
II期疾病患者局部区域复发率高，该组患者从更根治性的切除中获益。对于晚期肿瘤，仅行姑息治疗更为可取。
