Gallbladder cancer: An analysis of a series of 139 patients with invasion restricted to the subserosal layer
Gallbladder cancer: An analysis of a series of 139 patients with invasion restricted to the subserosal layer
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DOI：
10.1016/j.gassur.2005.11.003
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发表时间：
2006-02-01
影响因子：
3.2
通讯作者：
Maluenda, F
中科院分区：
文献类型：
--
作者：
de Aretxabala, X;Roa, I;Maluenda, F
目的是研究我们在一系列有潜在治愈性的阴囊下胆囊癌患者的管理经验，这些患者由作者前瞻性治疗。1988年4月至2004年7月，139例患者被纳入我们的前瞻性数据库。其中，120例采用开放手术，其余采用腹腔镜手术。只有8例患者在胆囊切除术前被怀疑诊断。肿瘤以腺癌为主。6例患者有表皮样瘤，1例有癌肉瘤。74例患者接受了再次手术，而55例（70.2%）患者可能进行了以治愈为目的的扩大胆囊切除术。手术死亡率为0%，手术并发症为16%。淋巴结转移10例（18.8%），肝脏转移7例（13.2%）。总生存率为67.7%，而在那些接受切除术的患者中，生存率为77%。通过多因素分析，发现淋巴结转移是影响预后的独立因素。胆囊癌侵犯浆膜下层的患者行扩大胆囊切除术的可行性使其具有良好的生存率。存在淋巴结转移是主要的预后不良因素，在这一特殊人群中应研究某种类型的辅助治疗。
The goal was to study our experience in the management of a series of patients with a potentially curative subscrosal gallbladder cancer who were prospectively treated by the authors. Between April 1988 and July 2004, 139 patients were enrolled in our prospective database. Of the above, 120 were operated on with an open procedure and the rest with laparoscopic surgery. In only eight patients was the diagnosis suspected before the cholecystectomy. The majority of tumors were adenocarcinoma. Six patients had an epidermoid tumor, and one had a carcinosarcoma. Of the patients, 74 underwent reoperation, while in 55 (70.2%) it was possible to perform an extended cholecystectomy with a curative aim. Operative mortality was 0%, and operative morbidity was 16%. Lymph node metastases were found in 10 (18.8%), while in 7 (13.2%) the liver was involved. The overall survival rate was 67.7%, while in those who underwent resection, the survival rate was 77%. Through the use of a multivariate analysis, the presence of lymph node metastasis was found to be an independent factor with respect to prognosis. The feasibility of performing an extended cholecystectomy in patients with gallbladder cancer and invasion of the subserosal layer allows for a good survival rate. The presence of lymph node metastases represents the main poor prognosis factor, and some type of adjuvant therapy should be studied in this particular group.