Unsuspected gallbladder cancer diagnosed during or after laparoscopic cholecystectomy
Unsuspected gallbladder cancer diagnosed during or after laparoscopic cholecystectomy
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DOI：
10.1002/jso.20944
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发表时间：
2008-03-01
影响因子：
2.5
通讯作者：
Kamiyama, Yasuo
中科院分区：
文献类型：
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作者：
Kwon, A-Hon;Imamura, Atsushi;Kamiyama, Yasuo
背景：腹腔镜胆囊切除术（LC）治疗意外胆囊癌（GBC）患者的长期预后尚不清楚。我们回顾性研究了冷冻切片检查的作用和LC.Methods：LC期间或之后发现的未被怀疑的GBC患者的预后进行了连续1,793例患者。结果：在所有这些患者中，38例（2.1%）在LC期间（28例）或LC后（10例）被组织病理学诊断为GBC。28例LC诊断的肿瘤分期为：pT 1a（17），pT 1b（2），pT 2（8）和pT 3（1）。术中冰冻切片检查的敏感性和特异性分别为90%和100%。10例LC后诊断为pT 1a（1）例，pT 2（9）例。生存率没有显着影响患者是否被诊断为GBC期间或之后LC.Conclusions：与未被怀疑的GBC的生存期相关的阶段，它被证实，仔细进行LC是足够的治疗阶段1A和B癌症。LC程序不会对意外GBC的预后产生不利影响，无论它是否在LC期间或之后被检测到。
Background: The long-term prognosis of laparoscopic cholecystectomy (LC) for patients with unsuspected gallbladder carcinoma (GBC) remains unclear. We investigated retrospectively the role of examination of frozen sections and the prognosis of patients with unsuspected GBC detected during or after LC.Methods: LC was performed on 1,793 consecutive patients. If a suspicious lesion was found, intraoperative frozen section examination was performed.Results: Of all these patients, 38 (2.1%) were histopathologically diagnosed as having a GBC during (28) or after LC (10). The tumor stages of the 28 diagnosed during LC were: pT1a (17), pT1b (2), pT2 (8), and pT3 (1). The sensitivity and specificity of intraoperative frozen section examination were 90 and 100%, respectively. On the other hand, those 10 cases diagnosed after LC had pT1a (1) and pT2 (9) tumors. Survival rates were not significantly affected by whether the patient was diagnosed with GBC during or after LC.Conclusions: The survival with unsuspected GBC was related to stage and it was confirmed that a carefully performed LC is adequate treatment for Stage 1A and B cancer. The LC procedure does not adversely affect the prognosis of unsuspected GBC, regardless of whether it is detected during or after LC.