论文部分内容阅读
目的分析不同手术方式对Ⅳ期胆囊癌预后的影响。方法对1997年6月～2001年5月间上海市172例Ⅳ期胆囊癌病例进行临床病理分析,并对获得随访的164例的预后与手术方式的关系进行探讨。数据分析采用Kaplan-Meier法。结果 172例中未手术者44例(25．6％),手术者128例(74．4％),其中包括单纯胆囊切除术45例(35．1％)、胆囊癌根治性切除术17例(13．3％)、胆囊癌扩大根治性切除术5例(3．9％)和剖腹探查术61例(47．7％)。在行根治性切除者中,Ⅳa和Ⅳb期的1年生存率分别为69．2％和40．7％,明显好于胆囊未切除或单纯切除者,在Ⅳa和Ⅳb期中各有2例存活期超过5年。结论有选择地进行Ⅳ期胆囊癌根治性或扩大根治性手术,有助于改善预后。
Objective To analyze the effect of different surgical methods on the prognosis of stage Ⅳ gallbladder cancer. Methods A total of 172 cases of stage Ⅳ gallbladder carcinoma in Shanghai from June 1997 to May 2001 were analyzed clinically and pathologically. The relationship between the prognosis and the surgical procedure of the 164 cases was followed up. Data analysis using Kaplan-Meier method. Results In 172 cases, 44 cases (25.6%) were operated without surgery and 128 cases (74.4%) were operated surgeries, including 45 cases (35.1%) of simple cholecystectomy, 17 cases of radical resection of gallbladder carcinoma (13.3%), enlarged radical resection of gallbladder in 5 cases (3.9%) and laparotomy in 61 cases (47.7%). Among the radical resections, the one-year survival rates in stage IVa and IVb were 69.2% and 40.7%, respectively, which were significantly better than those without or with excision of gallbladder, and two in IVa and IVb More than 5 years. Conclusion The selective radical surgery of Gallbladder carcinoma of stage Ⅳ or expansion of radical surgery may help to improve the prognosis.