Chijiiwa K, Tanaka M
Department of Surgery 1, Kyushu University Faculty of Medicine, Fukuoka, Japan.
Eur J Surg. 1996 Mar;162(3):211-6.
To assess the indications for, and limitations of, extended cholecystectomy in the treatment of carcinoma of the gall bladder. DESIGN. Retrospective study.
University hospital, Japan.
23 Patients who were operated on for carcinoma of the gall bladder, 1982-92 out of the total of 73 who presented to our department with the disease.
Extended cholecystectomy with en bloc lymph node dissection with or without resection of the extrahepatic bile duct, or hepatic resection, or pancreaticoduodenectomy, or a combination.
Outcome related to TNM classification.
7 Patients had stage I or II disease, and their cumulative five year survival rates (including one censored death) were 67% and 100%, respectively; 9 patients had stage III disease and of these 2/4 patients with T3N1 tumours died of their cancer, but the remaining 7 were alive a mean of 58 months later (though there was one censored death). Of the 7 with stage IV disease all but one were dead within 16 months despite more extensive surgery. The cumulative five year survival was 92% in patients with stage I, II and III (except T3N1 tumours).
Extended cholecystectomy with or without resection of the extrahepatic bile duct is indicated for patients with stage I, II, or III (except T3N1) tumours of the gall bladder.
评估扩大胆囊切除术治疗胆囊癌的适应证及局限性。设计：回顾性研究。
日本大学医院。
1982年至1992年间因胆囊癌接受手术的23例患者，这些患者来自本部门接诊的73例该疾病患者。
扩大胆囊切除术，整块切除淋巴结，可联合或不联合肝外胆管切除、肝切除、胰十二指肠切除术。
与TNM分期相关的结果。
7例患者为Ⅰ期或Ⅱ期疾病，其累积5年生存率（包括1例删失死亡）分别为67%和100%；9例患者为Ⅲ期疾病，其中2/4例T3N1肿瘤患者死于癌症，但其余7例在平均58个月后仍存活（尽管有1例删失死亡）。7例Ⅳ期疾病患者中，除1例患者外，其余患者尽管接受了更广泛的手术，但均在16个月内死亡。Ⅰ期、Ⅱ期和Ⅲ期（T3N1肿瘤除外）患者的累积5年生存率为92%。
对于胆囊Ⅰ期、Ⅱ期或Ⅲ期（T3N1除外）肿瘤患者，可施行扩大胆囊切除术，可联合或不联合肝外胆管切除。
