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腹腔镜技术以其创伤小在胆囊疾病的治疗中得到广泛认可,但对肿瘤的治疗仍很局限。本文报告腹腔镜胆囊切除术后胆囊癌伴腹壁切口种植转移1例。患者女,57岁,因反复右上腹痛10年,加重1周人当地医院,拟诊急性胆囊炎。全身麻醉下行腹腔镜胆囊切除术,术中发现胆囊周围严重粘连,胆囊肿大、积脓,肝组织正常,胆总管不扩张,行胆囊切除。术后病理证实为胆囊腺癌,侵及胆囊壁深层。术后6个月患者持续性右上腹痛。体检:剑突下及右上腹深压痛。
Laparoscopic technique is widely recognized for its minimal trauma in the treatment of gallbladder disease, but the treatment of tumors is still very limited. This article reports one case of gallbladder carcinoma with abdominal wall incision and metastasis after laparoscopic cholecystectomy. The female patient, 57 years old, was diagnosed with acute cholecystitis because of repeated right-upper abdominal pain for 10 years and an increase of 1 week in a local hospital. Under general anesthesia, laparoscopic cholecystectomy was performed. During the operation, severe adhesions around the gallbladder, gallbladder enlargement, empyema, normal liver tissue, common bile duct dilation, and gallbladder resection were found. Postoperative pathology confirmed gallbladder adenocarcinoma and invaded the deep layer of the gallbladder wall. Six months after surgery, the patient sustained persistent right upper abdominal pain. Physical examination: deep tenderness under the xiphoid and right upper quadrant.