临床误诊误治2017，Vol.30Issue(8)：8-11,4.DOI:10.3969/j.issn.1002-3429.2017.08.003
原发性胆囊癌误漏诊临床分析
Clinical Analysis of Missed Diagnosis or Misdiagnosed Patients with Primary Gallbladder Carcinoma
摘要
Abstract
Objective To summarize clinical features of primary gallbladder carcinoma in order to analyze causes of missed diagnosis or misdiagnosis of gallbladder stones before operation to provide prevention method.Methods Clinical data of 20 patients with primary gallbladder carcinoma confirmed by operation and postoperatively pathological results, who admitted during January 2011 and January 2014, was retrospectively analyzed.Results Among the 20 patients, 15 patients visited doctors for continuing pain in right upper quadrant of the abdomen;2 patients visited doctors for jaundice;3 patients visited doctors for nausea, vomiting, loss of appetite, obvious weight loss and fatigue.Abdominal mass was found in 1 patient.A total of 8 patients were confirmed diagnosis before surgery, 2 patients were suspected as having gallbladder carcinoma combined with cholecystolithiasis;5 patients were misdiagnosed as having cholecystolithiasis;5 patients were missed diagnosis.Among the 20 patients, 4 patients underwent gallbladder removal only;11 patients underwent gallbladder removal, hepatic tissue excision and partly lymphaden cleaning;5 patients underwent T tube drain outside the gallbladder;all patients were confirmed the diagnosis by rapid frozen pathology during the operation and (or) routine pathological examination after operation.There were 1 patient with biliary fistula, 1 patient with abscess and 3 patients with incisional infection after operation, and all patients were cured after symptomatic treatments.The survival rate of 20 patients before discharging was 100.0%.The median follow-up time was 2.3 years.At the end of the follow-up, 14 patients were survival, and 6 patients were died.Conclusion Gallbladder cancer and cholecystolithiasis have many similarities in clinical manifestations, and it is easily misdiagnosed.Patients with high risk factors of gallbladder cancer should take imaging and laboratory tests termly, and invasive examination if necessary in order to avoid missed diagnosis or misdiagnosis for primary gallbladder carcinoma.关键词
胆囊肿瘤/误诊/胆囊结石病/漏诊Key words
Gallbladder neoplasms/Misdiagnosis/Cholecystolithiasis/Missed diagnosis分类
医药卫生引用本文复制引用
王宇,段文涛..原发性胆囊癌误漏诊临床分析[J].临床误诊误治,2017,30(8):8-11,4.基金项目
四川省教育厅科研课题(12ZB042) （12ZB042）
