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目的探讨胆囊癌的早期诊断与治疗方法。方法通过对我院1996年至2007年收治的31例原发性胆囊癌的诊治体会结合文献资料进行回顾性分析。结果术前确诊率67.7%,手术切除率低(15/28),胆囊癌早期(Ⅰ、Ⅱ期)经目前常用的检查手段如B型超声、CT等检查诊断率极低,仅为11.1%～31.8%,早期病例多为术后组织病理学检查发现。内镜超声(EUS)可提高早期胆囊癌的检出率。胆囊癌恶性程度高,预后差,除早期病例外生存期多不超过1.5年,5年生存率低于4%。结论原发性胆囊癌主要检查手段为B型超声及CT,EUS早期诊断价值较高。作为临床医生,提高对胆囊癌的认识和警惕性,加强对胆囊癌高危人群的监测,尽量做到早期诊断,尽早使用以手术根治性切除术为主,联合放化疗等方法的综合治疗手段,对改善患者预后有重要意义。
Objective To investigate the early diagnosis and treatment of gallbladder cancer. Methods Through retrospective analysis of 31 cases of primary gallbladder carcinoma admitted to our hospital from 1996 to 2007 with experience of diagnosis and treatment. Results The preoperative diagnosis rate was 67.7%, the rate of surgical resection was low (15/28). The early diagnosis of gallbladder carcinoma (Ⅰ, Ⅱ) was very low with only 11.1% ~ 31.8%, early cases were mostly histopathological examination found. Endoscopic ultrasonography (EUS) can improve the detection rate of early gallbladder cancer. Gallbladder cancer has a high degree of malignancy and a poor prognosis. Survival of patients with gallbladder carcinoma is no more than 1.5 years and the 5-year survival rate is less than 4%. Conclusions The main diagnostic methods for primary gallbladder cancer are type B ultrasound and early detection of EUS and CT. As a clinician, to raise awareness and vigilance of gallbladder cancer, to strengthen the monitoring of high-risk groups of gallbladder cancer, try to do early diagnosis, early use of radical radical resection, combined with radiotherapy and chemotherapy and other methods of comprehensive treatment, To improve the prognosis of patients is of great significance.