中国普通外科杂志2025，Vol.34Issue(2)：215-221,7.DOI:10.7659/j.issn.1005-6947.250004
胆囊癌外科治疗中的难点、争议与思考
Challenges,controversies,and considerations in the surgical treatment of gallbladder cancer
摘要
Abstract
Gallbladder cancer is the most common malignant tumor of the biliary system,characterized by insidious growth,rapid progression,and skip metastasis.The 5-year overall survival rate is only 5%.Although targeted immunotherapies have emerged in recent years,they are still in the exploratory phase for the treatment of gallbladder cancer,and radical surgical resection remains the only potentially curative treatment.The main goal of surgery is to completely remove the tumor and perform systematic lymph node dissection to reduce the risk of recurrence.Thanks to advances in surgical techniques and continuous optimization of perioperative management,postoperative complications,and hospital mortality in patients undergoing extended radical surgery for gallbladder cancer have decreased.However,the complex mechanisms of gallbladder cancer spread and metastasis make it challenging to determine the optimal scope of surgical resection.Clinical guidelines from different countries and hepatobiliary surgery centers often vary on surgical options,especially regarding the reasonable extent of liver resection,the scope of lymph node dissection and its impact on prognosis,and whether routine extrahepatic bile duct resection should be performed.There remains significant controversy in these areas.Future extensive prospective cohort studies are still needed to provide more evidence-based medical data for the surgical treatment of gallbladder cancer.When designing a surgical plan,surgeons must consider preoperative examination results,intraoperative findings,and pathological evaluation of frozen sections.A balance must be struck between radical treatment and safety and effectiveness.The most appropriate surgical method for each patient should be chosen while also emphasizing establishing a multidisciplinary collaborative system.Based on accurate tumor staging,postoperative adjuvant therapies should be integrated to continue making progress in improving patient prognosis.关键词
胆囊肿瘤/肝切除术/淋巴结切除术/肝外胆管切除术Key words
Gallbladder Neoplasms/Hepatectomy/Lymph Node Excision/Extrahepatic Bile Duct Resection分类
临床医学引用本文复制引用
冯云翔,邱朋,王剑明..胆囊癌外科治疗中的难点、争议与思考[J].中国普通外科杂志,2025,34(2):215-221,7.基金项目
国家自然科学基金资助项目(82373032). （82373032）
