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目的 探讨胆囊癌的CT分级 ,术前对胆囊癌可切除性进行评价。方法 参照文献对 80例手术病理证实及影像学检查肯定诊断的胆囊癌进行CT分级 ,结合手术及病理结果对各级胆囊癌的手术可切除性进行评价。结果 本组中Ⅰ级 9例 ,Ⅱ级 18例 ,Ⅲ级 42例 ,Ⅳ级 11例。根治性手术切除 3 2例 ,其中Ⅰ级、Ⅱ级胆囊癌 2 7例 ,Ⅲ级胆囊癌 5例 ;姑息性切除 3 1例 ,均为Ⅲ级胆囊癌 ;因不能切除而行探察术 9例 ,其中Ⅲ级胆囊癌 6例 ,Ⅳ级胆囊癌 3例 ;另有 8例CT表现均为Ⅳ级 ,未能手术而采取其他治疗方法。结论 应用CT检查对胆囊癌进行分级 ,有助于术前对胆囊癌的手术可切除性进行评价 ,以选择最佳的治疗方案。
Objective To investigate the CT grade of gallbladder carcinoma and assess the resectability of gallbladder carcinoma before operation. Methods According to the literature, 80 cases of gallbladder carcinoma confirmed by operation and pathology and confirmed by imaging examination were graded by CT. Surgical resectability of gallbladder carcinoma was evaluated by operation and pathological results. Results In this group, there were 9 cases of grade Ⅰ, 18 cases of grade Ⅱ, 42 cases of grade Ⅲ and 11 cases of grade Ⅳ. Radical surgical resection in 32 cases, of which Ⅰ grade, grade Ⅱ gallbladder cancer 27 cases, grade Ⅲ gallbladder cancer in 5 cases; palliative resection in 31 cases, all grade Ⅲ gallbladder cancer; due to unresectable exploration and operation of 9 cases , Of which 6 were grade III gallbladder cancer and 3 were grade IV gallbladder cancer; and 8 of the 8 patients were all grade IV with CT findings. Other treatments were not available for surgery. Conclusions The grading of gallbladder carcinoma by CT examination is helpful to evaluate the resectability of gallbladder carcinoma before operation so as to select the best treatment plan.