Primary Carcinoma of the Gallbladder: Surgical Treatment and Prognosis

原發性膽囊癌之外科治療及預後

魏達成(Ta-Cheng Wei) ； 魏柏立(Po-Li Wei) ； 游憲章(Sen-Chang Yu) ； 許書劍(Shu-Chien Hsu)

《慈濟醫學雜誌》 8卷2期 (1996/06) Pp. 85-90

https://doi.org/10.6440/TZUCMJ.199606.0085

摘要

為了探討膽囊癌，我們評估過去10年間36位病人的期別、治療方法及組織形態之重要性。共有18位男性及18位女性。三分之二的病人年齡都在60歲以上。這些病人的切除率為66.7%。24位病人施行膽囊切除術。12位不能切除的病人，其生存期間只有半年。2位第一期及3位第二期的病人都活很好，最長的有超過十年生存者；7位第三期的病人，平均生存顯著地縮短為18.7個月，並只有一位在手術後生存42個月；6位第四期的病人，平均生存縮短至8.5個月；並且全部死於診斷後2個月至3年之間；18位第五期的病人，生存期間更縮短為4.9個月，並且合部死於14個月。關於預最重要的因素是癌症的期別或深度，及癌症的組織形態。在36位病人中有膽結石的有18位佔50%。全部膽囊癌的五年生存率是8.3%，而有切除病例的五年生存率是12.5%。在早期膽囊癌，正規的膽囊切除通常是足夠的；在進行性癌症，則要做更為要進取的外科治療。

關鍵字

膽囊癌 ； 膽囊切除術 ； 肝切除術

並列摘要

In order to study primary carcinoma of the gallbladder, we retrospectively evaluated the significance of stage, methods of treatment, and histological types on survival for 36 patients from 1983 to 1992. There were 18 moales and 18 females. A cholecystectomy was performed in each of the 24 patients (66.7%), while the carcinoma was unresectable in 12 patients (33.3%). Five patients who had had either stage Ⅰ (mucosa only) or stage Ⅱ (submucosa and muscularis) carcinoma were still alive and well as of the latest follow up, with the longest survival among them being more than 10 years. Seven patients had had stage Ⅲ (serosa) carcinoma. Their average duration of survival was only 18.7 months, and only one of them was alive and well 42 months postoperatively. Six patients had stage Ⅳ (serosa plus lymph nodes) carcinoma, and their average duration of survival was only 8.5 months. All stage Ⅳ patients died two months to three years after diagnosis. Eighteen patients had stage Ⅴ (extension to the liver and other organs) carcinoma. Their average duration of survival was only 4.9 months, and all died within 14 months. The most important factors determining prognosis were the depth or stage of invasion and the histological type of carcinoma. Gallstones were present in 18 (50%) of the 36 patients. The overall 5-year survival rate among the 36 patients was 8.3%; that of the 24 patients who underwent resection was 12.5%. In early stage of gallbladder carcinoma, a regular cholecystectomy is usually enough, In advanced gallbladder carcinoma, however, more aggressive surgical treatment should be considered.

並列關鍵字

gallbladder carcinoma ； cholecystectomy ； hepatectomy