CAJ | 학술논문

目的　总结原发性胆囊癌的治疗经验，探讨提高原发性胆囊癌生存率的方法。　方法回顾性分析了我院1986～1999年收治的69例胆囊癌病例资料。本组诊断依赖于临床表现和影像学检查，Ⅰ期4%，Ⅱ期7%，Ⅲ期15%，Ⅳ期17%，Ⅴ期57%。68%的病例行手术治疗。　结果　本组术前诊断率84%，B超和CT是提高诊断率的重要手段。手术切除率49%，长期存活者仍以Ⅰ、Ⅱ期病例为主，单纯胆囊切除术即可获得良好的存活率，3年为100%，Ⅲ期病例术后的2年存活率为50%。　结论　手术是治疗Ⅰ、Ⅱ、Ⅲ期病例的首选方法，手术能使Ⅳ、Ⅴ期患者的短期存活率稍有延长，早期诊断和手术切除是提高手术疗效的关键。对有高危因素的无症状胆囊结石和隆起样病变患者，应行预防性胆囊切除。
목적　 총결원발성담낭암적치료경험，탐토제고원발성담낭암생존솔적방법。　방법회고성분석료아원1986～1999년수치적69례담낭암병례자료。본조진단의뢰우림상표현화영상학검사，Ⅰ기4%，Ⅱ기7%，Ⅲ기15%，Ⅳ기17%，Ⅴ기57%。68%적병례행수술치료。　결과　 본조술전진단솔84%，B초화CT시제고진단솔적중요수단。수술절제솔49%，장기존활자잉이Ⅰ、Ⅱ기병례위주，단순담낭절제술즉가획득량호적존활솔，3년위100%，Ⅲ기병례술후적2년존활솔위50%。　 결론　 수술시치료Ⅰ、Ⅱ、Ⅲ기병례적수선방법，수술능사Ⅳ、Ⅴ기환자적단기존활솔초유연장，조기진단화수술절제시제고수술료효적관건。대유고위인소적무증상담낭결석화륭기양병변환자，응행예방성담낭절제。
Objective　 To evaluate the surgical treatment and to improve the prognosis of gallbladder cancer.　 Method　 A retrospective analysis was made on 69 cases of gallbladder cancer in PUMC hospital from 1986 to 1999. Diagnosis depends upon clinical manifestation, ultrasonography, and CT. In this group, stage Ⅰ cases took up to 4%，stage Ⅱ to 7%，stage Ⅲ to 15%，stage Ⅳ to 17%， and stage Ⅴ to 57%. 47 cases(68%) underwent surgery. 　 Result　 Preoperative diagnosis rate is 84% with resection rate of 49%. B-mode ultrasonic examination and CT scan were important to preoperative diagnosis. Long-term survivals were achieved almost only in cases of stage Ⅰ and Ⅱ with 3-year survival rate of 100%. 2-year survival rate in stage Ⅲ cases was 50%. 　 Conclusion　 Surgical operation is the first choice of therapy. Prophylactic cholecystectomy is recommended for high risk patients with asyptomatic gallstones or polypoid lesions.