根治性切除术治疗中晚期胆囊癌远期疗效分析

The long term effect analysis for radical cholecystectomy in the treatment of middle-late stage gallbladder cancer

摘要:

目的 探讨中晚期胆囊癌根治性切除术治疗的远期疗效。方法 回顾性分析该院73例中晚期胆囊癌患者的临床资料，分别采用非手术治疗、姑息性手术、单纯胆囊切除术、胆囊癌根治术、胆囊癌扩大根治术。结果 73例胆囊癌患者中，1年生存率60.27%（44/73），3年生存率32.88%（24/73），3年生存率19.18%（24/73）；随着Nevin分期的增加，患者平均生存时间、生存率均明显下降；Ⅰ-Ⅱ期、淋巴结无转移、肿瘤浅肌层浸润、切除治疗生存率明显高于Ⅲ-Ⅴ、淋巴结有转移、肿瘤深肌层浸润、姑息治疗（P <0.05、0.01）；Nevin分期、淋巴结转移程度、肿瘤浸润程度是影响胆囊癌远期疗效的主要因素。结论 应根据胆囊癌病理分期，采取以根治术为主的综合治疗方式，以期获得更好的临床预后。

Abstract:

【Objective】 To study long term effect of radical cholecystectomy in the treatment of middle-late stage gallbladder cancer. 【Methods】 The clinical data of 73 patients with middle-late stage gallbladder under non-surgical, palliative surgery, gallbladder radical cholecystectomy ,gallbladder enlarge radical resection treatment were retrospectively analyzed . 【Results】 73 patients with gallbladder cancer, 1 year survival rate was 60.27% (44/73), 3 year survival rate was 32.88% (24/73), 3 year survival rate was 19.18% (24/73);. With the increase of Nevin stage, the average survival time and survival rate were significantly decreased; Ⅰ-Ⅱ period, without lymph node metastasis, tumor excision with shallow muscular infiltration, the survival rate was significantly higher than Ⅲ - Ⅴ, lymph nodes with metastasis, tumor deep muscularis infiltration, palliative care (P < 0.05, 0.01); Nevin stage, lymph node metastasis, tumor infiltration degree were main factors influencing of gallbladder cancer forward curative effect. 【Conclusion】 According to the gallbladder pathological stage, radical cholecystectomy of comprehensive treatment can get better clinical prognosis.