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目的探讨腹腔镜胆囊切除术中漏诊胰腺癌的原因、术中探查胰腺的指征、漏诊后的早期诊断、再治疗方式的选择。方法回顾性分析1996年1月至2004年10月中山大学第三医院收治的外院腹腔镜胆囊切除术(LC)术中漏诊胰腺癌7例的临床资料,并对之进行随访。结果LC术后至再次就诊的时间为3d至5个月,平均61·3d,再次手术确诊后随访生存时间3~17个月,平均8·6个月。结论LC术前完善检查,重视高危人群的监测,术中明确探查胰腺的指征,是减少漏诊的重要措施。
Objective To investigate the causes of missed diagnosis of pancreatic cancer in laparoscopic cholecystectomy, intraoperative exploration of the pancreas indications, early diagnosis after missed diagnosis, and the choice of re-treatment. Methods The clinical data of 7 patients with missed diagnosis of pancreatic cancer during the operation of laparoscopic cholecystectomy (LC) in the Third Hospital of Sun Yat-sen University from January 1996 to October 2004 were retrospectively analyzed and followed up. Results The time from LC to re-visit was between 3 and 5 months (average 61.3 days). The follow-up time after reoperation was 3 to 17 months with an average of 8.6 months. Conclusion LC perfect examination before surgery, attention to the monitoring of high-risk groups, intraoperative clear exploration of the pancreas indication is an important measure to reduce missed diagnosis.