Clinical Management of Unsuspected Gallbladder Cancer During Laparoscopic Cholecystectomy（ Report of 16 Cases）_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

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付振刚 , 陈广瑜 , 成广海 , 王斌

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Keywords：

腹腔镜胆囊切除术; 意外胆囊癌

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目的　评价腹腔镜胆囊切除术（LC）中意外胆囊癌的诊断、处理及预后。
方法　对我院2000年1月至2010年1月期间5 832例行LC中16例意外胆囊癌患者的临床资料进行回顾性分析。
结果　16例意外胆囊癌中7例行LC，9例行开腹胆囊癌根治术。术后病理TNM分期：Ⅰ期10例，Ⅱ期4例，Ⅲ期2例。16例患者术后随访6～60个月，平均23.3个月。随访期内死亡15例。9例接受胆囊癌根治手术的患者术后1、3、5年生存分别为8/9、4/9及1/9，而7例仅行LC的患者术后1年生存为4/7，无生存超过2.5年者。
结论　LC术中应高度警惕意外胆囊癌的发生，意外胆囊癌多为早期，应及时中转开腹行胆囊癌根治术，仅行单纯的LC治疗效果欠佳。

Citation： 付振刚,陈广瑜,成广海,王斌. Clinical Management of Unsuspected Gallbladder Cancer During Laparoscopic Cholecystectomy（ Report of 16 Cases）. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2012, 19(2): 214-216. doi: Copy

1.	Kang CM, Choi GH, Park SH, et al．Laparoscopic cholecystectomy only could be an appropriate treatment for selected clinical R0 gallbladder carcinoma[J]．Surg Endosc, 2007, 21(9)：15821587．.
2.	Miller G, Jarnagin WR．Gallbladder carcinoma[J]．Eur J Surg Oncol, 2008, 34(3)：306-312．.
3.	Xu LN, Zou SQ．A clinicopathological analysis in unsuspected gallbladder carcinoma：a report of 23 cases[J]．World J Gastroenterol, 2007, 13(12)：1857-1860．.
4.	Contini S, Dalla Valle R, Zinicola R．Unexpected gallbladder cancer after laparoscopic cholecystectomy: an emerging problem? Reflections on four cases[J]．Surg Endosc, 1999, 13(3)：264267.
5.	Frauenschuh D, Greim R, Kraas E．How to proceed in patients with carcinoma detected after laparoscopic cholecystectomy[J]． Langenbecks Arch Surg, 2000, 385(8)：495-500．.
6.	石景森 ,孙学军．原发性胆囊癌诊治的历史、现状及展望[ J]．西安交通大学学报 (医学版 ), 2007, 28(5)：473-477．.
7.	石景森, 杨毅军, 赵凤林, 等．原发性胆囊癌 44年诊治的临床回顾[ J]．外科理论与实践 , 2001, 6(3)：137-141．.
8.	Wysocki A, Bobrzynski A, Krzywon J, et al．Laparoscopic cholecystectomy and gallbladder cancer[J]．Surg Endosc, 1999, 13(9)：899-901．.
9.	Weiland ST, Mahvi DM, Niederhuber JE, et al．Should suspected early gallbladder cancer be treated laparoscopically?[J]．J Gastrointest Surg, 2002, 6(1)：50-56．.
10.	Lundberg O, Kristoffersson A．Open versus laparoscopic cholecystectomy for gallbladder carcinoma[J]．J Hepatobiliary Pancreat Surg, 2001, 8(6)：525-529．.
11.	石景森 ,任予．腹腔镜手术意外发现胆囊癌的处理问题[ J]．中国微创外科杂志 , 2002, 2(增刊 )：10．.
12.	陶一明 ,杨连粤 ,常志刚 ,等．意外发现的早期胆囊癌的诊断与处理[ J]．中华肝胆外科杂志 , 2005, 11(6)：369-371．.
13.	Kapoor VK．Incidental gallbladder cancer[J]．Am J Gastroenterol, 2001, 96(3)：627-629．.
14.	彭淑牖 , 曹利平 , 牟一平．胆囊癌外科治疗的现状与展望[ J]．中华肝胆外科杂志 , 2001, 7(2)：67-69．.
15.	卢军华 ,杨田 ,郭红伟 ,等．意外胆囊癌的诊断与治疗[ J]．第二军医大学学报 , 2008, 29(6)：618-620．.

1. Kang CM, Choi GH, Park SH, et al．Laparoscopic cholecystectomy only could be an appropriate treatment for selected clinical R0 gallbladder carcinoma[J]．Surg Endosc, 2007, 21(9)：15821587．.
2. Miller G, Jarnagin WR．Gallbladder carcinoma[J]．Eur J Surg Oncol, 2008, 34(3)：306-312．.
3. Xu LN, Zou SQ．A clinicopathological analysis in unsuspected gallbladder carcinoma：a report of 23 cases[J]．World J Gastroenterol, 2007, 13(12)：1857-1860．.
4. Contini S, Dalla Valle R, Zinicola R．Unexpected gallbladder cancer after laparoscopic cholecystectomy: an emerging problem? Reflections on four cases[J]．Surg Endosc, 1999, 13(3)：264267.
5. Frauenschuh D, Greim R, Kraas E．How to proceed in patients with carcinoma detected after laparoscopic cholecystectomy[J]． Langenbecks Arch Surg, 2000, 385(8)：495-500．.
6. 石景森 ,孙学军．原发性胆囊癌诊治的历史、现状及展望[ J]．西安交通大学学报 (医学版 ), 2007, 28(5)：473-477．.
7. 石景森, 杨毅军, 赵凤林, 等．原发性胆囊癌 44年诊治的临床回顾[ J]．外科理论与实践 , 2001, 6(3)：137-141．.
8. Wysocki A, Bobrzynski A, Krzywon J, et al．Laparoscopic cholecystectomy and gallbladder cancer[J]．Surg Endosc, 1999, 13(9)：899-901．.
9. Weiland ST, Mahvi DM, Niederhuber JE, et al．Should suspected early gallbladder cancer be treated laparoscopically?[J]．J Gastrointest Surg, 2002, 6(1)：50-56．.
10. Lundberg O, Kristoffersson A．Open versus laparoscopic cholecystectomy for gallbladder carcinoma[J]．J Hepatobiliary Pancreat Surg, 2001, 8(6)：525-529．.
11. 石景森 ,任予．腹腔镜手术意外发现胆囊癌的处理问题[ J]．中国微创外科杂志 , 2002, 2(增刊 )：10．.
12. 陶一明 ,杨连粤 ,常志刚 ,等．意外发现的早期胆囊癌的诊断与处理[ J]．中华肝胆外科杂志 , 2005, 11(6)：369-371．.
13. Kapoor VK．Incidental gallbladder cancer[J]．Am J Gastroenterol, 2001, 96(3)：627-629．.
14. 彭淑牖 , 曹利平 , 牟一平．胆囊癌外科治疗的现状与展望[ J]．中华肝胆外科杂志 , 2001, 7(2)：67-69．.
15. 卢军华 ,杨田 ,郭红伟 ,等．意外胆囊癌的诊断与治疗[ J]．第二军医大学学报 , 2008, 29(6)：618-620．.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Clinical Management of Unsuspected Gallbladder Cancer During Laparoscopic Cholecystectomy（ Report of 16 Cases）

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