腹腔镜胆囊切除术后病理显示为胆囊癌再手术患者的临床分析

发布时间：2018-01-30 16:32

  本文关键词： 腹腔镜胆囊切除术 意外胆囊癌 再手术 回顾性研究　出处：《重庆医学》2017年33期 　论文类型：期刊论文

【摘要】：目的探讨胆囊结石行腹腔镜胆囊切除术后病理结果为胆囊癌再手术患者的处理策略。方法回顾性分析该院普外科2009-2013年因胆囊结石行腹腔镜胆囊切除术后病理发现为胆囊癌患者15例的临床资料。结果 15例患者腹腔镜胆囊切除术后3~5d病理检查为胆囊癌,肿瘤位于胆囊底4例,胆囊体2例,胆囊颈部9例;重度不典型增生局灶癌变1例,高分化腺癌2例,中分化腺癌9例,低分化腺癌3例;Tis 1例,pTⅠa 8例,pTⅠb 6例,胆囊管切缘均为阴性。15例患者均于胆囊切除术后6~11d再次开腹手术,肝十二指肠韧带淋巴结清扫术,TNM分期0期1例,Ⅰa期8例,Ⅰb期5例,Ⅲb期1例。术后随访时间28~79个月,1年生存率100%,2年生存率100%,3年生存率93%,5年生存率93%;1例Ⅲb期患者术后2年发现梗阻性黄疸,行经皮肝穿刺胆道引流治疗,3个月后死亡。术后均未发现刺口种植转移。结论腹腔镜胆囊切除术后病理发现的胆囊癌一般病期较早,行肝十二指肠韧带淋巴结清扫术预后相对较好。
[Abstract]:Objective to explore the management strategy of cholecystolithiasis after laparoscopic cholecystectomy for patients with gallbladder cancer reoperation. Methods the laparoscopic cholecystolithiasis was performed in general surgery department of our hospital from 2009 to 2013. Clinical data of 15 cases of gallbladder carcinoma found by pathology after resection. 15 patients were diagnosed as gallbladder carcinoma 3 days after laparoscopic cholecystectomy. The tumors were located at the bottom of the gallbladder in 4 cases, the body of the gallbladder in 2 cases and the neck of the gallbladder in 9 cases. There were 1 case of severe atypical hyperplasia, 2 cases of highly differentiated adenocarcinoma, 9 cases of moderately differentiated adenocarcinoma and 3 cases of poorly differentiated adenocarcinoma. One case of Tis with pT 鈪，

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