Abstract:

Extrahepatic bile duct resection in the treatment of T3,T4 gallbladder carcinoma ZHENG Ya-xin*, ZHONG Ming-an, HU Hai, et al. *Department of General Surgery, Shanghai East Hospital, Tong Ji University, Shanghai 200120,China Corresponding author: ZHENG Ya-xin, E-mail：yxzheng@shmu.edu.cn Abstract Objective To evaluate the clinical significance of extrahepatic bile duct resection （EBDR）in the treatment of T3,T4 gallbladder carcinoma（GC） Methods Palliative cholecystectomy (n=8), radical/extended radical resection without EBDR (n=9), and radical/ extended radical resection with EBDR (n=7) were employed performed in 24 patients with T3,T4 GC admitted between January 2004 and December 2006 at Shanghai East Hospital Affiliated to Tong Ji University. Clinicopathologic factors, postoperative complications and survival of the 3 group patients were studied. Results The mean survival of patients after surgery were 4, 6 and 18 months in the 3 groups respectively. There were no significant differences in the proportion of age, sex and postoperative complications among the 3 groups of patients. The 7 patients who underwent radical or extended radical resection with EBDR showed significantly better survival than another two group of patients in whom EBDR was not carried out(P=0.003). Conclusion EBDR is a necessary surgical procedure and is key to the improved survival of patients with T3,T4 GC undergoing radical or extended radical resection.

Key words: extrahepatic bile duct, gallbladder carcinoma

摘要：

目的 探讨肝外胆管切除在T3、T4胆囊癌根治术或扩大根治术的临床价值。方法 将同济大学附属东方医院普外科2004年1月至2006年12月间连续收治的术前或术中确诊的T3、T4胆囊癌随机分为姑息性胆囊切除（n＝8）、保留肝外胆管的胆囊癌根治术或扩大根治术（n＝9）、切除肝外胆管的胆囊癌根治术或扩大根治术（n＝7）三组。观察比较病人临床病理特征、术后并发症发生率及生存情况。结果 三组病人年龄、性别分布、并发症发生率差异均无统计学意义；病人术后中位生存期分别为4、6 和18个月，切除肝外胆管的胆囊癌根治术或扩大根治术的7例病人术后生存期与前两组病人相比差异具有统计学意义。结论 肝外胆管切除是T3、T4胆囊癌获得根治性切除、进而取得较好疗效的重要基础，在胆囊癌外科治疗中具有重要意义。

关键词: 胆囊肿瘤, 肝外肝管