中国实用外科杂志 ›› 2011, Vol. 31 ›› Issue (03): 209-212.

• 专题笔谈 • 上一篇    下一篇

胆囊癌扩大根治性切除术的范围与术式选择

俞文隆,杨晓宇,张永杰   

  1. 第二军医大学附属东方肝胆外科医院胆道二科,上海 200438
  • 出版日期:2011-03-01 发布日期:2011-05-30

  • Online:2011-03-01 Published:2011-05-30

摘要:

根治性切除仍是目前使胆囊癌病人有望获得治愈的唯一手段。胆囊癌侵袭性较高,因而扩大手术切除范围便成为现阶段外科治疗的必然选择。但胆囊癌扩大根治性切除相关手术风险巨大,对于晚期肿瘤疗效仍不令人满意。在保证手术安全的前提下,胆囊癌扩大根治性切除应力争获得R0根治。应根据病灶的大小、原发部位、周围脏器侵犯情况、肿瘤生长方式及是否有淋巴转移和血管侵犯,并充分考虑病人的身体状况、手术医生的业务能力和所在医疗机构的医疗条件,制定相应个体化的手术方案。

关键词: 胆囊癌, 扩大根治性切除

Abstract:

Role of aggressive surgical approach for gallbladder carcinoma with special consideration of the extent of radical resection        YU Wen-long,YANG Xiao-yu,ZHANG Yong-jie. Biliary Tract Surgery DepartmentⅡ, Eastern Hepatobilillary Surgery Hospital, the Second Military Medical University,  Shanghai200438,China
Corresponding author:ZHANG Yong-jie, E-mail:yjoy005@sina.com
Abstract    Currently, radical resection remains the only way to cure gallbladder carcinoma. Because of the high invasion of gallbladder carcinoma, an effort to improve the extent of surgical resection thus becomes the inevitable choice. However, the risk associated with the extended radical resection of gallbladder carcinoma is still high, and the prognosis of patients with gallbladder carcinoma treated in its advanced stage is still not satisfactory even with extensive radical surgery. With assuring operation safety as the premise, extensive radical resection of gallbladder carcinoma should should be performed in an attempt to achieve an R0 resection. To develop an individualized surgical plan, the following factors should be considered:  foci of the size, location and relative to neighboring organs, growth pattern of tumour and whether lymphatic and vascular invasion. The patient's physical conditions, surgeon’s skills and medical condition of hospital should be taken into account also.

Key words: gallbladder carcinoma, extended radical resection