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胆囊癌的外科治疗现状及进展
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Abstract:
通过查阅国内外相关文献，总结胆囊癌的外科治疗进展。胆囊癌目前仍以手术治疗为主，对病理证实的不同T分期胆囊癌手术方式选择差异较大，Tis期及T1a期胆囊癌行单纯胆囊切除术可达根治。对于T1b及T2期胆囊癌均推荐行根治性胆囊切除术联合区域淋巴结清扫，根治性胆囊癌切除术肝切除方式可选择肝楔形切除或肝S4b + 5段切除。对于T3及T4期胆囊癌，临床难以根治，扩大根治手术及扩大淋巴结清扫目前存在争议。肝胰十二指肠切除术可用于进展期胆囊癌的手术治疗。胆囊癌的诊疗目前仍需进一步的规范及更多的临床及基础研究，以进一步改善胆囊癌的预后。
The progress of surgical diagnosis and treatment of gallbladder cancer is summarized by referring to relevant literature research. Gallbladder cancer, at present, is still mainly treated by surgery, and surgical strategies for different T stages of gallbladder cancer vary greatly. Cholecystectomy for Tis stage and T1a stage gallbladder cancer, can achieve clinical radical resection. Cholecystectomy combined with regional lymph node clearance is recommended for T1b and T2 stage gallbladder cancer, including hepatic wedge resection or hepatic S4b + 5 segment resection for surgical strategies. For stage T3 and T4 gallbladder cancer, it is difficult to cure clinically, and there are controversies about expanded radical surgery and expanded lymph node dissection. Hepatopancreatoduodenectomy can be used in the surgical treatment of advanced gallbladder carcinoma. The diagnosis and treatment of gallbladder cancer still need to be further standardized and more clinical and basic studies to further improve the prognosis of gallbladder cancer.
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