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| 題 名 | 原發性膽囊癌十三例之臨床分析 |
|---|---|
| 作 者 | 金輔仁; | 書刊名 | 中華民國外科醫學會雜誌 |
| 卷 期 | 14:4 1981.12[民70.12] |
| 頁 次 | 頁362-367 |
| 關鍵詞 | 原發性膽囊癌; |
| 語 文 | 中文(Chinese) |
| 中文摘要 | 原發性膽囊癌是預後極為不良,且不易早期診斷的癌症。本篇分析從1977牟9月至1981年3月6個月內的13例患者。 術前的正確診斷率只有8%(1/13)。一年生存率30.8%(4/13)四例一年以上生存者的病理變化均局限於表肌肉層以上。無周邊組織的侵襲。且為膽囊可切除者。四例中有三例以急性膽囊炎為表徵,另有一例是膽囊切除後顯微病理下的意外發現。 由於早期診斷極為困難,我們認為必須對高罹息機會而有膽道結石的患者做詳細的術中檢查,配合冰凍切片的運用、以期提高意外發現率。參考外國文獻,為了防止預後良好者晚期再發,我們認為所謂的根治性膽囊切除(radical cholecystectomy)較為適宜。 |
| 英文摘要 | Primary carcinoma of the gall bladder is unusual but not rare, being the most common malignant lesion of the biliary tract and the fifth most common of the digestive tract. The lack of specific signs and symptoms prevents detection of gall bladder cancer in an early and resectable stage, and most carcinomas were unexpectedly or incidentally found at operations. From Spetember 1977 to March 1981, 13 cases of primary gall bladder cancer were found and analysed. They were followed for a period from 3 to 18 months. The accuracy rate for preoperative diagnosis is very low (8%, 1/13), and the case preoperati, diagnosis of gall bladder cancer was given was unresectable. Only 4 cases lived .more than one year after operation. The one year survival rate was 30.80%. They were all resectable, with no clinical invasion or metastasis to surrounding ortgans. The pathological pictures showed that the lesion were all confined to the superficial muscular layer. Three of the four cases with better result had clinical presentations of acute cholecystitis, and one stage cholecystectomy were performed because of the suspected malignancy. The other one was incidentally and unexpectedly diagnosed from microscopic examination of the resected gall bladder specimen. As for appropriate procedure for gall bladder cancer, especially for those carcinoma confined to mucosa or submucosa, we believe, as reported in the foreign literature, that a radical cholecystectomy, namely, cholecystectomy with wedge resection including 3-5 cm of normal liver and dissection of the regionallymphnode should be done in order to achieve long-term survival and prevent local recurrence. |
本系統中英文摘要資訊取自各篇刊載內容。