摘要
目的 总结 145 2例腹腔镜胆囊切除术 (L C)中早期胆囊癌、胆总管结石等隐性胆道疾病易被忽略的发生原因及治疗措施。方法 采用回顾性病例总结的方法 ,对胆囊结石、胆囊腺肌症、胆囊腺瘤导致癌变、胆总管结石易被术者忽略的原因进行分析。结果 12 6 9例胆结石患者中 2例癌变 ,179例息肉中 3例癌变 ,癌变率达 0 .3%。 10 5例胆总管直径 >0 .8cm者 ,术中造影 2 8例有胆管结石 ,发生率为 2 6 .6 %。结论 L C前临床医师应对胆囊巨大结石、胆囊壁增厚及有宽蒂息肉者高度重视 ,以免对癌肿误诊。对术前胆总管 >0 .8cm者 ,术中造影检查是必需的 。
Objective Summarizing the reson that the bile duct recessive dieases such as early gallbladder cancer,calculus of common bile duct,etc.are often neglected in LC and discussing corresponding methods of treatment.Methods Review 1452 cases of LC in our hospital.Results Two cases having carcinomatous change were found in 1269 cases of cholecystolithiasis and three were found in 179 cases of gallbladder polyp,the rate was 0.3%.Intraoperative cholangiography showed 28 patients having calculus of bile duct in 105 cases with the diameter of common bile duct>0.8cm,the rate was 26.6%.Conclusions High attention should be paid to the patients who have the great calculus of gallbladder,a thickened gallbladder wall or the polyp of wide stalk in order to avoid missing diagnosis.For patients with the diameter of common blie duct>0.8cm, the intraoperative cholangiography is necessary.
出处
《肝胆外科杂志》
2001年第2期112-113,共2页
Journal of Hepatobiliary Surgery
