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目的分析原发性胆囊癌术前误诊原因,探索有效的预防误诊的措施。方法对收治的52例原发性胆囊癌患者的临床资料进行回顾性分析,着重分析术前误诊原因。结果术前明确诊断19例(36.5%)。术前误诊33例(63.5%),其中误诊为胆囊结石13例,胆囊息肉样变8例,萎缩性胆囊炎4例,肝门部胆管癌3例,肝占位病变4例,Mirizzi综合征1例。术前误诊的33例术中明确诊断29例(55.8%),另有4例术后常规病理检查才明确诊断(7.7%)。误诊的原因较多,如缺乏特异性临床表现、并发胆囊其他疾病、过分依赖影像学检查、术中对可疑病灶未做快速冷冻病理检查等。结论对存在胆囊癌高危因素的可疑者应定期进行影像学检查,必要时进行有创性检查,甚至手术探查,术中进行快速冷冻切片病理检查,可做到早发现,早治疗,有助于改善胆囊癌患者预后。
Objective To analyze the causes of preoperative misdiagnosis of primary gallbladder cancer and explore effective measures to prevent misdiagnosis. Methods The clinical data of 52 cases of primary gallbladder carcinoma admitted to our hospital were retrospectively analyzed, and the causes of preoperative misdiagnosis were analyzed. Results 19 cases were diagnosed preoperatively (36.5%). There were 33 cases (63.5%) misdiagnosed before surgery, 13 cases were diagnosed as gallstones, 8 cases were polypoid gallbladder, 4 cases were atrophic cholecystitis, 3 cases were hilar cholangiocarcinoma, 4 cases were liver lesions, Mirizzi’s syndrome 1 case. Thirty-three cases of preoperative misdiagnosis were diagnosed correctly in 29 cases (55.8%), and another 4 cases were diagnosed by routine pathological examination (7.7%). Misdiagnosis of many reasons, such as the lack of specific clinical manifestations, complicated by other gallbladder diseases, over-reliance on imaging studies, intraoperative suspicious lesions have not done rapid frozen pathological examination. Conclusions Suspected persons with high risk of Gallbladder cancer should undergo regular radiological examinations and invasive examination if necessary. Surgical exploration and rapid frozen section biopsy during operation may help to detect early and early treatment, Improve the prognosis of patients with gallbladder cancer.