Preoperative diagnoses and identification rates of unexpected gallbladder cancer.
Preoperative diagnoses and identification rates of unexpected gallbladder cancer.
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DOI：
10.1371/journal.pone.0239178
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发表时间：
2020
期刊：
影响因子：
3.7
通讯作者：
Sada M
中科院分区：
文献类型：
--
作者：
Fujiwara K;Masatsugu T;Abe A;Hirano T;Sada M
意外胆囊癌(UGBC)常见于手术中或手术后切除的胆囊壁。一些报告指出了UGBC对所有手术的识别率，但关于特定胆囊病的UGBC识别率的数据很少。本研究旨在明确在接受腹腔镜胆囊切除术(LSC)的患者中，UGBC的发生率和根据术前诊断分类的可疑因素。我们记录了自1991年以来在日本佐田医院外科进行的所有LSC手术的数据，并分析了28年的数据。我们使用卡方检验和Kaplan-Meier分析进行这项回溯性病例对照研究。UGBC的识别率为0.69%(63/9186)。其中急性胆囊炎13例(1.3%)，良性肿瘤16例(2.4%)，慢性胆囊炎或胆囊炎28例(2.0%)，胆囊结石3例(0.054%)。除胆囊结石外，UGBCs中老年患者(≥60岁)的比例明显高于根据术前诊断最终诊断为良性的患者(p≤0.0014)。在预诊为良性肿瘤的患者中，胆囊壁增厚率高于良性肿瘤(分别为69.2%和27.9%；p=0.0011)。与预诊为慢性胆囊炎的胆囊癌相比，预诊为急性胆囊炎的胆囊癌T2-T4发生率较高(分别为100%和64.3%)，生存率较低(P=0.0149)。UGBC的识别率取决于术前诊断，范围为0.054%至2.4%。年龄较大(≥为60岁)可能与UGBC有关，与慢性胆囊炎诊断前相比，急性胆囊炎的诊断前可能提示更晚期的癌症。
Unexpected gallbladder cancer (UGBC) is sometimes found in the resected gallbladder of patients during or after surgery. Some reports have indicated UGBC identification rates for all gallbladder surgeries, but scarce data are available for the UGBC identification rates for specific gallbladder diseases. The present study was performed to clarify UGBC rates and the factors suspicious for UGBC categorized according to preoperative diagnoses, in patients undergoing laparoscopic cholecystectomy (LSC). We recorded data for all LSC surgeries performed in the Department of Surgery, Sada Hospital, Japan since 1991, and analyzed the 28-year data. We used the chi-square test and Kaplan–Meier analysis for this retrospective case–control study. The UGBC identification rate was 0.69% (63/9186 patients). The UGBC identification rates categorized according to the preoperative diagnoses were 1.3% (13/969) for acute cholecystitis, 2.4% (16/655) for benign tumor, 2.0% (28/1383) for chronic cholecystitis or cholecystitis, and 0.054% (3/5585) for cholecystolithiasis. The percentage of older patients (≥ 60 years) was significantly higher in UGBCs compared with cases finally diagnosed as benign in each group categorized according to the preoperative diagnoses (p≤0.0014), except for cholecystolithiasis. In cases pre-diagnosed as benign tumor, UGBCs were associated with higher rates of thickened gallbladder wall compared with benign tumor (69.2% vs. 27.9%, respectively; p = 0.0011). UGBCs pre-diagnosed as acute cholecystitis had higher T2–T4 rates (100% vs. 64.3%, respectively; p<0.05) and lower survival rates (p = 0.0149) than UGBCs pre-diagnosed with chronic cholecystitis. UGBC identification rates depend on the preoperative diagnosis and range from 0.054% to 2.4%. Older age (≥ 60 years) could be related to UGBC, and a pre-diagnosis of acute cholecystitis might indicate more advanced cancer compared with a pre-diagnosis of chronic cholecystitis.
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DOI：
10.1007/s00534-004-0910-y
发表时间：
2004-01-01
期刊：
JOURNAL OF HEPATO-BILIARY-PANCREATIC SURGERY
影响因子：
--
作者：
Akyürek, N;Irkörucü, O;Tatlicioglu, E
通讯作者：
Tatlicioglu, E
影响因子：
4.3
作者：
Choi, Kui Sun;Choi, Sae Byeol;Choi, Sang Yong
通讯作者：
Choi, Sang Yong
影响因子：
2.6
作者：
Kim, Ji Hun;Kim, Wook Hwan;Kim, Myung Wook
通讯作者：
Kim, Myung Wook
影响因子：
2.5
作者：
Kwon, A-Hon;Imamura, Atsushi;Kamiyama, Yasuo
通讯作者：
Kamiyama, Yasuo
影响因子：
1.3
作者：
Dincel, Oguzhan;Goksu, Mustafa;Hatipoglu, Hamit Sinan
通讯作者：
Hatipoglu, Hamit Sinan