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为了探讨胆囊癌的早期诊断和合理治疗，总结我院过去15年间收住58例胆囊癌病例的诊疗经验。患者平均年龄65．8±9．5岁，4O例伴有胆囊结石，平均胆石症病程11年。B超诊断胆囊癌的敏感性为67．9%，CT为61．8％。组织学类型以腺癌为主。44例作了手术，肿瘤切除率为39．7％，根治性切除率为17.2／，两者1、3、5年生存率分别为43.4%、31.9%、23.1％和88.9%、62.5％、28.3％。总5主生存率5.1％。作者认为：(1）胆囊息肉样病及应密切随访；（2)年龄＞60岁或胆石症病史超过10年，尤其影像学检查示胆囊壁增厚或萎缩性胆囊炎应切除胆囊；（3）胆囊标本应常规剖拉，有助于早期发现胆囊癌。治疗上I期病例采用胆囊切除术，Ⅱ和Ⅲ期病例应未用扩大胆囊切除附加淋巴结清扫。
In order to investigate the early diagnosis and reasonable treatment of gallbladder cancer, we summarized the experience of diagnosis and treatment of 58 cases of gallbladder cancer in our hospital over the past 15 years. The average age of the patients was 65.8 ± 9.5 years old. Gallstones were associated with 4O cases. The average course of cholelithiasis was 11 years. The sensitivity of B-mode diagnosis of gallbladder cancer was 67.9% and CT was 61.8%. The histological type is mainly adenocarcinoma. Forty-four patients underwent surgery with a tumor resection rate of 39.7% and a radical resection rate of 17.2. The 1-, 3-, and 5-year survival rates were 43.4%, 31.9%, 23.1%, and 88.9%, 62.5%, respectively. 28.3%. The total 5 primary survival rate is 5.1%. The authors believe that: (1) gallbladder polypoid disease and close follow-up; (2) age> 60 years or history of cholelithiasis more than 10 years, especially imaging examination showed gallbladder wall thickening or atrophic cholecystitis should be removed gallbladder; (3 ) Gallbladder specimens should be routinely dissected to help early detection of gallbladder cancer. Cholecystectomy was used for the treatment of stage I cases, and expanded lymph node dissection was not used for stage II and III cases.