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胆囊癌的外科治疗

Surgical treatment for carcinoma of the gallbladder.

作者信息

Polański J A, Białek P, Biejat Z, Kisiel M, Makowska H, Filipowicz K, Kwiatkowski H

机构信息

3rd Department of Surgery, 2nd Faculty of Medicine, Warsaw Medical School, Poland.

出版信息

Mater Med Pol. 1995 Jan-Mar;27(1):11-3.

PMID:8569269
Abstract

Carcinoma of the gallbladder has always been associated with dismal prognosis. In this study we present single institution experience in surgical treatment for gallbladder cancer obtained during last five years. Even with recent improvement in diagnostic imaging modalities gallbladder malignancies are still diagnosed too late. The choice of operative procedure for a treatment of gallbladder carcinoma still remained the open question. Carcinoma of the gallbladder is not very common disease in Europe, but some how more common in Poland. According to the National Register, based on a study from 1991, 1863 cases of death from the gallbladder carcinomas were registered [13]. At the same time 2015 new cancer cases were diagnosed and registered. These gave us a crude rate of new cases in 1991 as follows: 2.7/100,000 man and 7.7/100,000 female. Those were even higher for some voivodeships in 1988, for example: Lódź (M = 3.95/100,000, F = 10.58/100,000) and Warsaw (M = 3.15/100,000, F = 7.59/100,000). Carcinoma of the gallbladder has always been associated with dismal prognosis. This was essentially the result of the slow and asymptomatic growth of the neoplasm that infiltrates the surrounding structures, such as the portal vein, hepatic artery and liver parenchyma, making a curative surgical treatment almost impossible. So there is a general impression that no progress has been made during last 20 years in the treatment for carcinoma of the gallbladder [2, 7, 9, 12]. However, in last years, we have observed improvements in diagnostic, surgical and intensive care techniques that allowed to offer a wider range of surgical and non-surgical options to our patients [1, 3, 4, 6, 8].(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

胆囊癌一直与预后不良相关。在本研究中,我们展示了过去五年间在单一机构进行胆囊癌手术治疗的经验。即便近期诊断成像方式有所改进,但胆囊恶性肿瘤仍诊断过晚。治疗胆囊癌的手术方式选择仍是个悬而未决的问题。胆囊癌在欧洲并非常见疾病,但在波兰相对更为常见。根据国家登记处基于1991年的一项研究,登记了1863例因胆囊癌死亡的病例[13]。与此同时,2015例新的癌症病例被诊断并登记。这使我们得出1991年新病例的粗略发病率如下:男性为2.7/10万,女性为7.7/10万。1988年某些省份的发病率甚至更高,例如:罗兹(男性 = 3.95/10万,女性 = 10.58/10万)和华沙(男性 = 3.15/10万,女性 = 7.59/10万)。胆囊癌一直与预后不良相关。这主要是由于肿瘤生长缓慢且无症状,会浸润周围结构,如门静脉、肝动脉和肝实质,使得根治性手术治疗几乎不可能。所以普遍认为在过去20年里胆囊癌的治疗没有取得进展[2, 7, 9, 12]。然而,近年来,我们观察到诊断、手术和重症监护技术有所改进,这使得我们能够为患者提供更多的手术和非手术选择[1, 3, 4, 6, 8]。(摘要截断于250字)

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