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來源資料
相關文獻
- Primary Carcinoma of the Gallbladder: Results of Surgery--A Retrospective Study
- 膽囊癌及膽胰特殊內視鏡檢查
- Xanthogranulomatous Cholecystitis Combined with Gall Bladder Cancer and Cholecystogastric Fistula--A Case Report
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- Primary Carcinoma of the Gallbladder: Surgical Treatment and Prognosis
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- Gingival Metastasis from Gallbladder Cancer
- 膽囊癌
- 原發性膽囊癌手術前診斷
頁籤選單縮合
題 名 | Primary Carcinoma of the Gallbladder: Results of Surgery--A Retrospective Study=手術治療膽囊癌的回顧性分析 |
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作 者 | 楊圳隆; 劉建良; 劉滄柏; 李居仁; 黃共璠; | 書刊名 | 中華醫學雜誌 |
卷 期 | 62:2 1999.02[民88.02] |
頁 次 | 頁68-75 |
分類號 | 416.247 |
關鍵詞 | 膽囊癌; 根除性手術; Gallbladder carcinoma; Radical surgery; |
語 文 | 英文(English) |
中文摘要 | 背景:膽囊癌往往預後不佳,但隨肝膽檢查技術的改進、可切除病例的增加及根 除性手術的進行,均可影響治療結果。 方法:本回溯性研究, 從 1982 年 1 月至 1995 年 12 月的 14 年間,共收納 53 例接受 手術的膽囊癌病人。把他們以 Nevin 法分期,則第 I 期有 6 例、II 期 10 例、III 期 9 例、IV 期 4 例、 VI 期 24 例;施行手術的方式:單純性膽囊切除者 21 例、膽囊切除加 膽道引流者 7 例、擴大手術者 15 例, 而只作剖腹手術者 6 例,作胃腸引流手術者 4 例 。 治療結果以 K-aplan- Meie,氏法及 logrank 檢驗作分析。 結果: 1 年及 5 年的存活率分別為 50% 及 19.2%; 若以 Ne 而 n 分期, 則第 I 期的 5 年存活率為 100 %,第 II 期為 60 %,第 III 期為 33 %,第 IV 期 25 %,第 VI 期為 0 %。第 III、IV 期的病例接受根除性手術,其累積存活率比接受單純性膽囊切除術在統計 學上有較佳之結果 (p<0.01)。第 I 期只有 I 例作根除性手術,但 5 年存活率為 100 %; 第 II 期有 5 例作單純膽囊切除,有 2 例出現早期轉移; 第 III 期的只作膽囊切除,但 也都因轉移而存活不超過2年。 結論:結果顯示第 III、IV 期病人應作根除性手術,才能得到較佳的療效。 對於高度懷疑 的病例,術前應作詳細檢查,術中切開膽囊迭檢以確立診斷,並即時作適當的切除,以提高 患者的生存率。 |
英文摘要 | Background. The development of hepatobiliary imaging modalities has resulted in earlier detection of gallbladder cancer. This is a retrospective evaluation of surgical resection of gallbladder cancer. Methods. Records of 53 patients with gallbladder carcinoma who underwent surgical resection in the past 14 years were examined. Patients were staged according to the Nevin system: six had Nevin stage I disease; 10, stage II; 9, stage III; four, stage IV; and 24 had stage V cancer. Forty-three patients were thought to have resectable lesions. Of these, 14 had extended cholecystectomy, 21 simple cholecystectomy, seven simple cholecys- tectomy with biliary drainage and one patient had radical cholecystectomy with pancreaticoduodenectomy. Prognoses were analyzed in relation to pathologic staging and surgical procedures. Results. The overall one-year and five-year survival rates were 50% and 19.2%, respectively. The five-year survival rate for Nevin stage I was 100%; for stage II, 60%; stage III, 33%; stage IV, 25 % and for stage V, 0%. Radical surgery led to a better cumulative survival rate for Nevin stages III and IV (p < 0.01) than did simple cholecystectomy. Five Stage II cases were treated with simple cholecystectomy but two patients had early metastasis. Four stage III patients underwent simple cholecystectomy and three had metastasis within one year. Conclusions. Based on these results, stage III and IV tumors require extended procedures for better survival. A high index of suspicion for the disease, careful intraoperative examination of the gallbladder specimen and earlier, more aggressive treatment may improve patient survival. |
本系統中英文摘要資訊取自各篇刊載內容。