原发性胆囊癌诊治体会(附52例病例报道)

目的 提高原发性胆囊癌的早期诊断率。方法 回顾性总结我院1988年至1998年52例胆囊癌的病例。结果 术前诊断率：90.3%，其中属胆囊癌早期诊断率25％（12例），总手术切除率55.8%，晚期胆囊癌手术切除率17.8％。结论 早期诊断是提高治疗效果的关键，以下特征应引起我们对胆囊癌高度注意：（1）50岁以上有反复发作的胆囊炎，胆囊结石病史；（2）先天胆道畸形者；（3）胆囊壁局限性增厚，囊壁不规则；（4）胆囊腔内大于1cm息肉样病变，不规则；（5）胆囊萎缩；（6）胆囊内的占位不随体位的改变而移动；（7）区域淋巴结肿大。

Experience in diagnosis and treatment of primary carcinoma of gallbladder: a report of 52 cases

Objective To promote the rate of early confirmed diagnosis of primary carcinoma of gallbladder. Methods The data of 52 patients with primary carcinoma of gallbladder treated in our Hospital from 1988 to 1998 were retrospectively analyzed. Results The preoperative diagnostic rate was 90.3%, in which only 12 cases were of early diagnosis of the carcinoma (23%). The total operative resection rate was 55.8%, in which 17.8% were of late stage carcinoma. Conclusions Early diagnosis is the crucial factor for increasing successful treatment rate. We should pay special attention to the following features of carcinoma of gallbladder: 1) The patients aged over 50 have recurrent cholecystitis and past history of gall stone. 2) Congenital malformation of the bile duct. 3) Local thickening and irregularity of the gallbladder wall. 4) Polypoid lesion larger than 1 cm inside the gallbladder. 5) Atrophic gallbladder. 6) Intraluminal space of the gallbladder does not move along with the changes of the posture. 7) Enlargement of the regional lymph nodes.