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目的 探讨胆囊癌区域淋巴结转移情况及影响因素 ,为手术切除范围提供依据。方法回顾性分析 3 4例胆囊癌根治术患者的临床病理资料。结果 总体淋巴结转移率为 68% ( 2 3 / 3 4 ) ,其中PT10 ( 0 / 3 ) ,PT2 4 3 % ( 3 / 7) ,PT385 % ( 11/ 13 ) ,PT482 % ( 9/ 11)。按淋巴结部位转移率分别为 :胆囊管淋巴结 2 9% ( 10 / 3 4 ) ,胆总管旁淋巴结 4 4 % ( 15 / 3 4 ) ,肝门淋巴结 18% ( 6/ 3 4 ) ,肝动脉旁淋巴结 2 4 % ( 8/3 4 ) ,门静脉旁淋巴结 2 1% ( 7/ 3 4 ) ,胰十二指肠后上淋巴结 3 8% ( 13 / 3 4 ) ,腹主动脉旁淋巴结 4 / 6。结论 肿瘤浸润深度与淋巴结转移密切相关 ,淋巴结清扫范围应根据术中探查和冰冻病理提供的资料确定。
Objective To investigate the regional lymph node metastasis and influencing factors of gallbladder carcinoma, and provide basis for the scope of surgical resection. Methods The clinical and pathological data of 34 patients with gallbladder carcinoma undergoing radical resection were analyzed retrospectively. Results The overall lymph node metastasis rate was 68% (23/34), of which PT10 (0/3), PT2 4 3% (3/7), PT38% (11/13), and PT482% (9/11). The lymph node metastasis rate was 2 9% (10/34) in the cystic duct lymph node, 4 4% (15/34) in the parachordal lymph node, 18% (6/34) in the hilar lymph node, and next to the hepatic artery. Lymph node 24% (8/34), paravenous lymph node 2% (7/34), pancreatic-duodenal upper lymph node 38% (13/34), paraaortic lymph node 4/6 . Conclusion The depth of tumor invasion is closely related to lymph node metastasis. The range of lymph node dissection should be determined based on the data provided by intraoperative exploration and frozen pathology.