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目的 总结原发性胆囊癌的治疗经验 ,探讨提高原发性胆囊癌生存率的方法。方法回顾性分析了我院 1986～ 1999年收治的 6 9例胆囊癌病例资料。本组诊断依赖于临床表现和影像学检查 ,Ⅰ期 4% ,Ⅱ期 7% ,Ⅲ期 15 % ,Ⅳ期 17% ,Ⅴ期 5 7%。 6 8%的病例行手术治疗。结果 本组术前诊断率 84% ,B超和CT是提高诊断率的重要手段。手术切除率 49% ,长期存活者仍以Ⅰ、Ⅱ期病例为主 ,单纯胆囊切除术即可获得良好的存活率 ,3年为 10 0 % ,Ⅲ期病例术后的 2年存活率为 5 0 %。结论 手术是治疗Ⅰ、Ⅱ、Ⅲ期病例的首选方法 ,手术能使Ⅳ、Ⅴ期患者的短期存活率稍有延长 ,早期诊断和手术切除是提高手术疗效的关键。对有高危因素的无症状胆囊结石和隆起样病变患者 ,应行预防性胆囊切除
Objective To summarize the experience in the treatment of primary gallbladder cancer and explore ways to increase the survival rate of primary gallbladder cancer. Methods The retrospective analysis of the data of 69 cases of gallbladder carcinoma admitted to our hospital from 1986 to 1999. The diagnosis in this group depends on clinical manifestations and imaging examinations, with 4% in phase I, 7% in phase II, 15% in phase III, 17% in phase IV, and 57% in phase V. Surgical treatment was performed in 68% of cases. Results The preoperative diagnosis rate was 84% in this group. B-ultrasonography and CT were important methods to improve the diagnostic rate. The surgical resection rate was 49%. The long-term survivors were still mainly in stage I and II cases. Simple cholecystectomy could obtain a good survival rate, 30% was 10%, and the stage 2 survival rate was 5 after surgery. 0 %. Conclusions Surgery is the first choice for the treatment of stage I, II, and III cases. Surgery can make the short-term survival rate of patients with stage IV and V slightly prolonged. Early diagnosis and surgical resection are the key to improve the curative effect. Asymptomatic cholecystectomy should be performed for patients with asymptomatic gallstones and protuberances with high risk factors