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目的探讨意外胆囊癌的临床病理特点及治疗措施。方法回顾性分析本院24例LC下意外胆囊癌(UGC组)的临床资料,并与同期收治的其他胆囊癌(GC组)对比。结果UGC组早期(ⅠA期)比例(25.0%,6/24)明显高于GC组(5.0%,2/40)(P=0.02);晚期(Ⅲ、Ⅳ)(16.7%,4/24)比例明显低于GC组(77.5%,31/40)(P<0.01);手术根治切除率(83.3%,20/24)明显高于GC组(32.6%,29/89)(P<0.01);UGC组的总体1、3、5年生存率(83%,46%,21%)及平均生存期和中位生存期(37±7,27月)均明显高于GC组(36%,19%,6%;21±6,6月)(P<0.01)结论UGC早期病例相对高及晚期病例相对少,根治性切除率相对高,预后相对好;诊断应重视高危因素和重视术中快速病检;除Tis及T1a期外,其他分期一律应行再次手术争取根治性切除。
Objective To investigate the clinicopathological features and treatment of unexpected gallbladder cancer. Methods The clinical data of 24 cases of unexpected gallbladder cancer (LC) under LC in our hospital were retrospectively analyzed and compared with those of other gallbladder carcinomas (GC group) admitted in the same period. Results The proportion of early stage ⅠA (25.0%, 6/24) in UGC group was significantly higher than that in GC group (5.0%, 2/40) (P = 0.02) (83.3%, 20/24) in GC group was significantly lower than that in GC group (32.6%, 29/89) (P <0.01) ; The overall 1,3,5-year survival rates (83%, 46%, 21%) and mean survival and median survival (37 ± 7, 27 months) in the UGC group were significantly higher than those in the GC group (36% 19%, 6%; 21 ± 6, 6 months) (P <0.01) .Conclusion The early stage of UGC is relatively high with relatively few advanced cases, the radical resection rate is relatively high and the prognosis is relatively good. Rapid pathological examination; except Tis and T1a period, the other staging should be repeated surgery for radical resection.