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目的:探讨胆囊结石确诊后行腹腔镜胆囊切除术而漏诊胃窦癌的原因,提出预防措施。方法:分析兰州军区兰州总医院2000-01/2008-12因胆石症收治同时合并胃癌漏诊8例临床资料,介绍诊断和治疗过程。结果:8例术后因症状无改善或进一步加重继续检查发现病变,发现胃癌距胆囊切除术3周~21个月,患者生存4.7~31.3个月。结论:术前仔细询问病史并胃镜检查;术中重视对胆囊邻近脏器的探查;加强术后随访是防止胃癌漏诊的重要措施。
Objective: To investigate the causes of laparoscopic cholecystectomy and missed diagnosis of gastric antrum after choledocholithiasis, and to put forward preventive measures. Methods: The clinical data of 8 cases with missed diagnosis of gastric cancer admitted to Lanzhou General Hospital of Lanzhou Military Command from January 2000 to December 2008 with cholelithiasis were analyzed. The diagnosis and treatment course were introduced. Results: Eight cases of postoperative symptoms or no further improvement to further check the pathological changes found in gastric cancer from cholecystectomy for 3 weeks to 21 months, the patients survive 4.7 to 31.3 months. Conclusion: Preoperative history and gastroscopy were carefully asked; intraoperative exploration of the adjacent organs of the gallbladder was emphasized; and postoperative follow-up was an important measure to prevent misdiagnosis of gastric cancer.