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目的 :探讨胆囊癌致胆管梗阻的诊断与治疗方法。方法 :术前经B超诊断符合率为 3 1.2 5 % ,CT诊断符合率为 44 .75 % ,术中快速病理确诊 6例 ,单纯胆囊切除 4例 ,根治切除 3例 ,胆囊切除和胆管内引流 3例 ,探查胆管置管外引流 4例 ,探查和胆管置管内引流 2例 ,术后辅以区域性放射 6例 ,血管内介入治疗 4例。结果 :手术切除率 62 .5 % ,根治率 18.75 % ,9例 1年内死亡 ,余 7例于术后 2～ 3年内死亡。结论 :综合应用影像学等检查技术 ,提高术前原发性胆囊癌的早期诊断率 ,术中仔细探查 ,及时的快速病理检查和积极的根治切除以及胆管内外引流处理 ,术后辅以区域性放疗和介入治疗 ,是提高胆囊癌治疗效果 ,延长患者生存期的必要措施。
Objective: To investigate the diagnosis and treatment of gallbladder obstruction caused by gallbladder carcinoma. Methods: The preoperative diagnosis by B ultrasound was 3 1.2 5%. The coincidence rate of CT diagnosis was 44.75%. 6 cases were diagnosed by rapid pathology, 4 cases were treated by simple cholecystectomy, 3 cases were treated by radical resection and 3 cases were cholecystectomy and bile duct Drainage in 3 cases, exploration of bile duct drainage in 4 cases, exploration and biliary drainage in 2 cases, postoperative adjuvant regional radiotherapy in 6 cases, endovascular interventional treatment in 4 cases. Results: The resection rate was 62.5% and the radical cure rate was 18.75%. Nine cases died within one year and the remaining seven cases died within 2-3 years after operation. Conclusion: The comprehensive application of imaging techniques to improve the early diagnosis of preoperative gallbladder cancer, intraoperative exploration, prompt and rapid pathological examination and radical radical resection and internal and external drainage of bile duct treatment, supplemented by regional Radiotherapy and interventional therapy is necessary to improve the therapeutic effect of gallbladder cancer and prolong the survival of patients.