中国内镜杂志2011，Vol.17Issue(6)：561-564,568,5.
腹腔镜对可疑早期胆囊癌的治疗
Laparoscopic treatment of suspected early-stage gallbladder carcinoma
宋士鹏 1张阳德 2周永升1
作者信息
- 1. 内蒙古医学院第三附属医院普外科,内蒙古包头014010
- 2. 中南大学卫生部肝胆肠外科研究中心,湖南长沙410008
- 折叠
摘要
Abstract
[Objective] To examine the feasibility of the laparoscopic approach for treating suspected early-stage gallbladder carcinoma. [Methods] Prospective study from the Third Affiliated Hospital of Inner Mongolia Medical College from March 2005 to December 2008, the laparoscopic approach was considered for treating 25 patients with suspected gallbladder carcinoma at T2 or less without liver invasion based on the preoperative computed tomographic scan. To further exclude liver invasion, preoperative endoscopic ultrasonography (US) and laparoscopic US were additionally performed. Frozen biopsy was performed after completing the cholecystectomy. If carcinoma was found, laparoscopic lymphadenectomy was performed. [Results] Two patients who had liver invasion on endoscopic US underwent open surgery. An additional 3 patients who had liver invasion noted on laparoscopicUS had their surgical procedure converted to laparotomy. Finally, 20 patients underwent a laparoscopic procedure. With combined computed tomography, endoscopic US, and laparoscopic US, the negative predictive value for excluding hepatic invasion reached 100%. For the 9 patients who had benign lesions noted on their frozen biopsies, their laparoscopic surgical procedure was completed. The remaining 11 patients who had gallbladder carcinoma underwent additional laparoscopic lymphadenectomy. During laparoscopic lymphadenectomy 1 conversion occurred owing to bleeding, themedian operative time was 185 minutes, and the median blood loss was 60 mL The complication rate was 18.2% and the median postoperative hospital stay was 5 days. After a median follow-up of 25 months, all 11 patients who underwent laparoscopic lymphadenectomy survived without any evidence of recurrence or metastasis. [Conclusion] Laparoscopic treatment is feasible and safe in selected patients with early-stage gallbladder carcinoma.关键词
胆囊癌/内镜超声/腹腔镜超声/腹腔镜淋巴结清除Key words
gallbladder carcinoma/ endoscopic ultrasonography/ laparoscopic ultrasonography/ laparoscopic lymphadenectomy分类
医药卫生引用本文复制引用
宋士鹏,张阳德,周永升..腹腔镜对可疑早期胆囊癌的治疗[J].中国内镜杂志,2011,17(6):561-564,568,5.
