頁籤選單縮合
題名 | 膽囊息肉樣病變--以48手術例探討其臨床意義 |
---|---|
作者姓名(中文) | 吳錫金; | 書刊名 | 中華民國外科醫學會雜誌 |
卷期 | 20:6 1987.11[民76.11] |
頁次 | 頁493-500 |
分類號 | 416.247 |
關鍵詞 | 膽囊息肉樣病變; |
語文 | 中文(Chinese) |
中文摘要 | 過去三年多以來,台中榮總經由超音波掃描術及口服膽囊攝影術檢查共發現有136例膽囊息肉樣病變。大部分的病例均無臨床症狀,但是有48例出現右上腹疼痛、噁心、嘔吐及腹脹等消化不適症狀,偶而亦有發燒成畏寒。這48例均接受剖腹探查:病理檢查結果為膽醇沉著症25例,發炎性息肉14例,腺肌瘤4例,膽囊癌3例及腺瘤2例。他們全接受膽囊摘除術,但有1例膽囊癌尚包括楔狀肝切除及局部淋巴結清除術。另外兩例膽囊癌係膽囊摘除後意外發現,而且癌細胞已侵入漿膜下層。在我們的手術例中均無死亡或併發症發生,且術後症狀消失,3例膽囊癌病人目前均健在。我們的結論是當超音波或膽囊攝影發現膽囊內有息肉樣病變,而且病人有症狀時,如果手術危險性小,為了解除症狀或是平期發現膽囊癌,尤其是病變大於1 cm或是併存有膽結石時,均應接受膽囊摘除術,籍以改善生活品質及提高膽囊癌的存活率。 |
英文摘要 | From Sept. 1982 to Dec. 1985, 136 cases of polypoid lesions of the gall bladder were diagnosed by ultrasound and/or additional oral cholecystogram at VGH-Taichung. Most of them were asymptomatic. In 48 cases, RUQ pain, nausea and/or vomiting, fever and chills were noted simultaneously. All 48 cases underwent exploratory laparotomy, which disclosed localized or diffuse cholesterolosis (25), inflammatory polyps (14), adenomyoma (4), gall bladder cancer (3), or adenoma (2). Cholecystectomy was performed in each case, with one case of gall bladder cancer also receiving wedge resection of the liver bed and dissection of the lymph nodes in the hepatoduodenal ligament. Two other cases of gall bladder cancer were unexpectedly found after cholecystectomy; the cancerous cells had already invaded the subserosal layer. No mortality or mobidity were noted in this series, and all patients were symptom-free postoperatively. Because it was difficult to make a preoperative differential diagnosis between a benign lesion and malignancy, if the lesion were larger than 1 cm or caused symptoms, but had low surgical risk, operation should be performed to relieve symptoms or for possible early detection and management of gall bladder cancer, with the goal of higher survival rate. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。