摘要
目的探讨无症状性胆囊结石与胆囊癌发生之间的关系及其手术时机。方法总结1982年1月至1999年12月手术切除胆囊结石4249例,合并胆囊癌23例的临床病理资料,以无症状性胆囊结石与症状性胆囊结石为两个研究单元,对比胆囊癌的发病情况及预后。结果无症状性胆囊结石组发现胆囊癌 Nevin Ⅰ、Ⅱ期18例,Ⅲ期1例,Ⅳ期2例。症状性胆囊结石组发现 Nevin Ⅲ期胆囊癌2例。手术后随访5年以上16例,5年生存率69.56％。结论重新评估无症状性胆囊结石的治疗策略,不应过分强调胆囊癌高危因素的存在,宜采取积极的手术治疗态度。
Objective To investigate the relationship between asymptomatic gallstone and the development of gallbladder carcinoma as well as the timing for cholecystectomy.Methods The clinical and pathological data of 4 249 cases of gallstone treated with cholecystectomy from January 1982 to December 1999 in our hospital were retrospectively analyzed.Twenty-three cases of gallbladder carci- noma were found.The occurrence of gallbladder carcinoma and its prognosis were compared between the patients with asymptomatic gallstone and those with symptomatic gallstone.Results There were 18 cases of Nevin Ⅰ and Ⅱ,one case of Nevin Ⅲ and 2 cases of Nevin Ⅳ gallbladder carcinoma in the asymptomatic group.Two cases of Nevin Ⅲ gallbladder carcinoma were found in the symptomatic group.Postoperative follow-up in all these 23 patients received different kinds of curative resection for 14 months to 11 years showed that the 5-year survival rate was 69.56%.Conclusions The therapeu- tic strategy for asymptomatic gallstone should be reevaluated.Positive attitude to surgical treatment of gallstone without over-emphasizing the presence of high-risk factors for gallbladder carcinoma should be advocated.
出处
《中华肝胆外科杂志》
CAS
CSCD
2001年第12期714-716,共3页
Chinese Journal of Hepatobiliary Surgery
