| 曾严 张艳林 张杰峰 张毅 邓和军.32 例腹腔镜胆囊切除术意外胆囊癌的临床诊治[J].,2014,14(7):1320-1322 |
| 32 例腹腔镜胆囊切除术意外胆囊癌的临床诊治 |
| Clinical Diagnosis and Treatment of 32 Cases with Unexpected GallbladderCarcinoma after Laparoscopic Cholecystectomy |
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| DOI： |
| 中文关键词: 腹腔镜 胆囊切除术 意外胆囊癌 |
| 英文关键词: Laparoscope Cholecystectomy Unexpected gallbladder carcinoma |
| 基金项目:国家自然科学基金项目（30901919） |
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| 中文摘要: |
| 目的：分析腹腔镜胆囊切除术中或术后发现意外胆囊癌的临床特点，探讨其诊治措施。方法：回顾性分析2008 年1 月～
2012 年12 月在我院行腹腔镜胆囊切除术治疗发现的意外胆囊癌患者共计32 例的临床资料和随访结果。结果：24 例患者经术中
快速冷冻病理证实，其中12 例中转开腹行胆囊癌根治术；8 例患者经术后病理证实，6 例行二次开腹手术。Nevin I期4例，Nevin
II期20 例，Nevin III期5 例，Nevin IV 期2 例，Nevin V期1例。32 例患者均顺利出院，住院时间6~24d，平均住院时间（13.8± 8.1）
d。32 例中有30 例获得随访，2 例失访，随访时间2～49个月，平均（24.2± 14.6）个月。生存23 例，死亡7 例，分别死于术后2、3、5、
12、14、18和32 个月。术后有5 例患者出现并发症，2 例胆囊积液，2例切口感染和1 例胆瘘，经对症治疗后好转。结论：加强对胆
囊癌的警惕与认识，腹腔镜胆囊切除术中或术后发现意外胆囊癌后应根据具体情况，选择最佳手术方式治疗，提高根治切除率，
延长患者生存期。 |
| 英文摘要: |
| Objective:To analyze the clinical characteristics of 32 cases with unexpected gallbladder cancer after laparoscopic
cholecystectomy and to further explore more effective diagnosis and treatment methods.Methods:A retrospective analysis of 32 cases
with unexpected gallbladder cancer after laparoscopic cholecystectomy were conducted from Jan. 2008 to Dec. 2012. Results:24 patients
were identified as gallbladder cancer by intraoperative frozen-section examination, and 12 of them were converted to laparotomy; 8
patients were proved by postoperative pathology, 7 of themunderwent a secondary laparotomy. Nevin stage: Nevin I in four cases, Nevin
II in 20 cases, Nevin III in 5 cases, Nevin IV in 2 cases and Nevin V in 1 cases. 32 patients leaved from hospital, with the hospitalization
time 6~24 d, with an average time of (13.8 ± 8.1) d. 30 cases of 32 were followed up for 2 to 49 months, with an average time of (24.2
± 14.6) months, 2 patients were lost during the process of follow up. 23 patients survived, and 7 died of postoperative for 2, 3, 5, 12, 14,
18 and 32 months, respectively. 5 patients occurred complications after surgery, two cases of gallbladder hydrops, two cases of wound
infection and one case of biliary fistula, and all were improved after symptomatic treatment.Conclusion:It is necessary to strengthen
vigilance and awareness of unexpected gallbladder. According to the specific circumstances, we choose the best surgical approach that
can improve the radical resection rate and prolong the survival time. |
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