本文關(guān)鍵詞： 腹腔鏡膽囊切除術(shù) 意外膽囊癌 再手術(shù) 回顧性研究　出處：《重慶醫(yī)學(xué)》2017年33期 　論文類型：期刊論文

【摘要】：目的探討膽囊結(jié)石行腹腔鏡膽囊切除術(shù)后病理結(jié)果為膽囊癌再手術(shù)患者的處理策略。方法回顧性分析該院普外科2009-2013年因膽囊結(jié)石行腹腔鏡膽囊切除術(shù)后病理發(fā)現(xiàn)為膽囊癌患者15例的臨床資料。結(jié)果 15例患者腹腔鏡膽囊切除術(shù)后3~5d病理檢查為膽囊癌,腫瘤位于膽囊底4例,膽囊體2例,膽囊頸部9例;重度不典型增生局灶癌變1例,高分化腺癌2例,中分化腺癌9例,低分化腺癌3例;Tis 1例,pTⅠa 8例,pTⅠb 6例,膽囊管切緣均為陰性。15例患者均于膽囊切除術(shù)后6~11d再次開腹手術(shù),肝十二指腸韌帶淋巴結(jié)清掃術(shù),TNM分期0期1例,Ⅰa期8例,Ⅰb期5例,Ⅲb期1例。術(shù)后隨訪時(shí)間28~79個(gè)月,1年生存率100%,2年生存率100%,3年生存率93%,5年生存率93%;1例Ⅲb期患者術(shù)后2年發(fā)現(xiàn)梗阻性黃疸,行經(jīng)皮肝穿刺膽道引流治療,3個(gè)月后死亡。術(shù)后均未發(fā)現(xiàn)刺口種植轉(zhuǎn)移。結(jié)論腹腔鏡膽囊切除術(shù)后病理發(fā)現(xiàn)的膽囊癌一般病期較早,行肝十二指腸韌帶淋巴結(jié)清掃術(shù)預(yù)后相對(duì)較好。
[Abstract]:Objective to explore the management strategy of cholecystolithiasis after laparoscopic cholecystectomy for patients with gallbladder cancer reoperation. Methods the laparoscopic cholecystolithiasis was performed in general surgery department of our hospital from 2009 to 2013. Clinical data of 15 cases of gallbladder carcinoma found by pathology after resection. 15 patients were diagnosed as gallbladder carcinoma 3 days after laparoscopic cholecystectomy. The tumors were located at the bottom of the gallbladder in 4 cases, the body of the gallbladder in 2 cases and the neck of the gallbladder in 9 cases. There were 1 case of severe atypical hyperplasia, 2 cases of highly differentiated adenocarcinoma, 9 cases of moderately differentiated adenocarcinoma and 3 cases of poorly differentiated adenocarcinoma. One case of Tis with pT 鈪，

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