中文English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Issue 4
Apr.  2016

A prognostic analysis of laparoscopic versus radical cholecystectomy for T1b unsuspected gallbladder carcinoma

DOI: 10.3969/j.issn.1001-5256.2016.04.031
  • Published Date: 2016-04-20
  • Objective To investigate the surgical treatment and prognosis of T1 b unsuspected gallbladder carcinoma( UGC). Methods Twenty- two patients with T1 b UGC admitted to our hospital were enrolled as subjects. The information on clinical pathology,radiological examination,laboratory tests,surgical treatment,and postoperative follow- up were analyzed in patients. The survival rate and recurrence were compared between patients treated with radical cholecystectomy and laparoscopic cholecystectomy. The Kaplan- Meier method was used to calculate survival rates,and the log- rank test was used for survival difference analysis. Comparison of categorical data was made by Fisher's exact test. Results The 1-,3-,and 5- year accumulative survival rates in all patients with T1 b UGC were 100%,89. 7%,and82. 8%,respectively; there was no significant difference in the 5- year accumulative survival rate between patients treated with laparoscopic cholecystectomy and radical cholecystectomy( 84. 6% vs 75. 0%,χ~2= 0. 000,P = 0. 991); two( 15. 4%) out of thirteen patients treated with laparoscopic cholecystectomy respectively; one( 12. 5%) out of eight patients treated with radical cholecystectomy had recurrence,there was no significant difference between the two groups( P > 0. 05). Conclusion Radical cholecystectomy is a superior therapy for T1 b UGC over laparoscopic cholecystectomy.

     

  • [1]GOURGIOTIS S,KOCHER HM,SOLAINI L,et al.Gallbladder cancer[J].Am J Surg,2008,196(2):252-264.
    [2]EDGE SB,BYRD DR,COMPTON CC,et al.AJCC cancer staging manual[M].7th ed.New York:Springer,2009:211-217.
    [3]SHI JS,ZHENG JB,LI ZF,et al.Surgical management of gallbladder cancer:key issues[J].J Clin Hepatol,2012,28(7):499-501.(in Chinese)石景森,郑见宝,李宗芳,等.当前胆囊癌根治切除应注意的问题[J].临床肝胆病杂志,2012,28(7):499-501.
    [4]YOON JH,LEE YJ,KIM SC,et al.What is the better choice for T1b gallbladder cancer:simple versus extended cholecystectomy[J].World J Surg,2014,38(12):3222-3227.
    [5]GOETZE TO,PAOLUCCI V.Immediate re-resection of T1 incidental gallbladder carcinomas:a survival analysis of the German Registry[J].Surg Endosc,2008,22(11):2462-2465.
    [6]LEE SE,JANG JY,LIM CS,et al.Systematic review on the surgical treatment for T1 gallbladder cancer[J].World J Gastroenterol,2011,17(2):174-180.
    [7]WAKAI T,SHIRAI Y,YOKOYAMA N,et al.Early gallbladder carcinoma does not warrant radical resection[J].Br J Surg,2001,88(5):675-678.
    [8]HA TY,YOON YI,HWANG S,et al.Effect of reoperation on long-outcome of p T1b/T2 gallbladder carcinoma after initial laparoscopic cholecystectomy[J].J Gastrointest Surg,2015,19(2):298-305.
    [9]LIU XX,LIU YY.Recent advances in radical cholecystectomy treatment of gallbladder cancer[J].J Clin Hepatol,2012,28(7):496-498.(in Chinese)刘晓欣,刘允怡.胆囊癌根治切除新进展[J].临床肝胆病杂志,2012,28(7):496-498.
    [10]YOU DD,LEE HG,PAIK KY,et al.What is an adequate extent of resection for T1 gallbladder cancers?[J].Ann Surg,2008,247(5):835-838.
    [11]FETZNER UK,HLSCHER AH,STIPPEL DL.Regional lymphadenectomy strongly rccommended in T1b gallbladder cancer[J].World J Gastroenterol,2011,17(38):4347-4348.
    [12]YAMAMOTO H,HAYAKAWA N,KITAGAWA Y,et al.Unsuspected gallbladder carcinoma after laparoscopic cholecystectomy[J].J Hepatobiliary Pancreat Surg,2005,12(5):391-398.
    [13]WULLSTEIN C,WOESTE G,BARKHAUSEN S,et al.Do complications related to laparoscopic cholecystectomy influence the prognosis of gallbladder cancer?[J].Surg Endosc,2002,16(5):828-832.
    [14]CLEMENTE G,NUZZO G,de ROSE AM,et al.Unexpected gallbladder cancer after laparoscopic cholecystectomy for acute cholecystitis:a worrisome picture[J].J Gastrointest Surg,2012,16(8):1462-1468.
    [15]KIM JH,KIM WH,KIM JH,et al.Unsuspected gallbladder cancer diagnosed after laparoscopic cholecystectomy:focus on acute cholecystitis[J].World J Surg,2010,34(1):114-120.
    [16]LEE JM,KIM BW,KIM WH,et al.Clinical implication of bile spillage in patients undergoing laparoscopic cholecystectomy for gallbladder cancer[J].Am Surg,2011,77(6):697-701.
    [17]XU XQ,LIU W,LI BL,et al.Unsuspected gallbladder cancer during or after laparoscopic cholecystectomy[J].Chin Med Sci J,2013,28(2):102-106.
    [18]LIU QD,XU XY,ZHOU NX.Port-site metastases:considerations for laparoscopic oncologic surgeries[J].J Clin Hepatol,2013,29(3):175-177,183.(in Chinese)刘全达,许小亚,周宁新.穿刺孔转移:审视腹腔镜肿瘤外科的安全性[J].临床肝胆病杂志,2013,29(3):175-177,183.
    [19]LIU B,HUANG XQ,WANG J,et al.Hepatobiliary malignancies with cutaneous metastases:an analysis of 8 cases[J].World Chin JDig,2010,18(20):2166-2170.(in Chinese)刘博,黄晓强,王敬,等.肝胆恶性肿瘤皮肤转移8例[J].世界华人消化杂志,2010,18(20):2166-2170.
  • Relative Articles

    [1]Jianhui LU, Yongli LI, Ruifang GUO, Rongquan XUE. Clinical features of patients with recurrent primary common bile duct stones after cholecystectomy[J]. Journal of Clinical Hepatology, 2025, 41(1): 118-126. doi: 10.12449/JCH250118
    [2]Yuehua WANG, Hua JIANG, Lianghong TENG, Huanli DUAN, Bixiao CUI, Dongmei WANG. Giant adenoma of the gallbladder misdiagnosed as gallbladder carcinoma: A case report[J]. Journal of Clinical Hepatology, 2024, 40(4): 794-796. doi: 10.12449/JCH240424
    [3]Yashu ZHOU, Yihui MA, Jiaxin PEI, Yuanyuan MENG, Peng GUO, Xiyue LIANG, Taiying LU. Clinical diagnosis, treatment, and prognosis of gallbladder sarcomatoid carcinoma: An analysis of 16 cases[J]. Journal of Clinical Hepatology, 2024, 40(4): 767-772. doi: 10.12449/JCH240420
    [4]Zhuoran LIU, Jing LI, Yu ZHOU, Pingfu XIONG, Li YANG, Wenguang FU. Value of the nomogram based on HALP score in predicting the prognosis of patients with hepatocellular carcinoma after hepatectomy[J]. Journal of Clinical Hepatology, 2023, 39(7): 1600-1608. doi: 10.3969/j.issn.1001-5256.2023.07.014
    [5]Bingqi MA, Huijuan MENG, Wei ZHANG, Xiaofeng DONG, Meng WANG, Jie DOU, Yuning WU, Shiping LI. Prognostic value of several immune and inflammatory indices after curative-intent resection for intrahepatic cholangiocarcinoma[J]. Journal of Clinical Hepatology, 2022, 38(9): 2061-2066. doi: 10.3969/j.issn.1001-5256.2022.09.021
    [6]Zang YouYa, Long PeiYun, Han ZhiWei, Wang Huan, Ruan JingSheng, Huang Shan, Wu GuoBin, Chen Chuang. Establishment and verification of a nomogram for predicting patient prognosis after hepatectomy for hepatocellular carcinoma[J]. Journal of Clinical Hepatology, 2019, 35(10): 2225-2230. doi: 10.3969/j.issn.1001-5256.2019.10.019
    [7]Zhang HaiWen, Wang Meng, Wang ChuanLei, Jie EnBo, Wang GuangYi. Clinical application of hepatopancreatoduodenectomy in treatment of advanced gallbladder cancer[J]. Journal of Clinical Hepatology, 2017, 33(7): 1397-1399. doi: 10.3969/j.issn.1001-5256.2017.07.043
    [8]Li ZhenLi, Yang Tian. Diagnosis and surgical treatment of xanthogranulomatous cholecystitis[J]. Journal of Clinical Hepatology, 2017, 33(2): 247-252. doi: 10.3969/j.issn.1001-5256.2017.02.007
    [9]Zhang ZhiQuan. Analysis of prognostic factors for patients treated by radical resection of liver metastases from colorectal cancer[J]. Journal of Clinical Hepatology, 2015, 31(9): 1455-1457. doi: 10.3969/j.issn.1001-5256.2015.09.022
    [10]Zhang TingTing, Zhao XiangQian, Liu Zhe, Jiao ShunChang, Bai Li. Preoperative neutrophil-lymphocyte ratio is an independent prognostic factor for hepatocellular carcinoma after radical resection[J]. Journal of Clinical Hepatology, 2015, 31(6): 927-931. doi: 10.3969/j.issn.1001-5256.2015.06.024
    [11]Tang Xiao. Curative effect and prognostic impact of radical resection assisted by transcatheter arterial chemoembolization in treatment of intrahepatic cholangiocarcinoma[J]. Journal of Clinical Hepatology, 2015, 31(2): 236-239. doi: 10.3969/j.issn.1001-5256.2015.02.022
    [12]Zhang XiaoXia, Huang XiaoDong, Ke WenJie. Meta- analysis of association between cholecystectomy and colorectal adenoma[J]. Journal of Clinical Hepatology, 2014, 30(2): 162-165. doi: 10.3969/j.issn.1001-5256.2014.02.016
    [13]Zhang HePing. Primary choledocholithiasis after cholecystectomy: a clinical analysis of 70 cases[J]. Journal of Clinical Hepatology, 2014, 30(11): 1135-1137. doi: 10.3969/j.issn.1001-5256.2014.11.010
    [14]Wang QiuSheng. Mechanism and prevention for complications of laparoscopic cholecystectomy[J]. Journal of Clinical Hepatology, 2012, 28(1): 11-13.
    [15]Wang GuangYi, Qiu Wei, Sun XiaoDong, Liu YaHui, Lu: GuoYue. The clinical applications of transumbilical single port laparoscopic cholecystectomy (report of 15 cases)[J]. Journal of Clinical Hepatology, 2012, 28(2): 111-113.
    [16]Wang YiFei, Lu LunGen. Recognition of the related issues on postcholecystectomy[J]. Journal of Clinical Hepatology, 2011, 27(9): 909-911.
    [17]Gu HuaPing, Liu YanRu, Shang PeiZhong. Expression of CD44v6 and C-erbB-2 in gallbladder neoplasms and their relatonship[J]. Journal of Clinical Hepatology, 2002, 18(6): 370-371.
  • Cited by

    Periodical cited type(21)

    1. 尹国锋,牛志鹏. 腹腔镜胆囊切除术中意外胆囊癌的临床诊治分析. 江西医药. 2023(01): 77-79+83 .
    2. 厉冰,刘赟,孙万日. 不同手术方式对T_(1b)期胆囊癌患者的治疗效果. 癌症进展. 2023(11): 1231-1233+1276 .
    3. 王学明. 胆囊癌诊治中腹腔镜技术的应用进展. 中国医疗器械信息. 2022(02): 38-40 .
    4. 吴俊樟,汪凤莲,王江波. 不同剂量舒芬太尼在胆囊癌手术麻醉前使用的疗效对比. 吉林医学. 2022(08): 2140-2143 .
    5. 韩莹,刘丽娜,齐向秀. 两种手术方式治疗原发性胆囊癌的近中期疗效及ROC曲线生存分析. 中华普外科手术学杂志(电子版). 2021(02): 215-217 .
    6. 张凌宵,李永盛,吴文广,陈庚,刘颖斌. 胆囊癌腹腔镜外科治疗安全性的荟萃分析. 中华医学杂志. 2020(42): 3342-3349 .
    7. 秦建民. 意外胆囊癌误漏诊原因与临床防治策略. 世界华人消化杂志. 2020(23): 1167-1176 .
    8. 李彩霞,王世东. 加速康复理念和疼痛管理在行胆囊癌切除术患者中的应用效果评估. 中国普通外科杂志. 2019(02): 241-246 .
    9. 张毅,闫国诚,王双全. 单纯、根治性切除术治疗Ⅱ期原发性胆囊癌的临床效果比较. 临床医学研究与实践. 2019(09): 80-82 .
    10. 周锋,宋涛,郭成. 腹腔镜胆囊切除术治疗早期胆囊癌患者的临床观察. 中国肿瘤临床与康复. 2019(09): 1036-1038 .
    11. 李俊生,张彦,李文峰. LC治疗胆囊癌的效果及其对免疫功能的影响. 中国现代普通外科进展. 2019(08): 633-635 .
    12. 王耀东,崔虎啸,徐梦辉,时永,侯森. 腹腔镜胆囊切除术治疗早期胆囊癌的临床效果. 河南医学研究. 2019(21): 3894-3895 .
    13. 王巧琳,段春燕,付艳丽,林燕. 蒿芩清胆汤联合化疗治疗晚期胆囊癌疗效及其对患者血清T淋巴细胞亚群水平的影响. 长春中医药大学学报. 2018(01): 85-88 .
    14. 纪秀波,苏久辉. 不同麻醉药物对腹腔镜胆囊切除术后早期认知功能的影响. 长春中医药大学学报. 2018(04): 779-781 .
    15. 朱宏亮,陈鹏,胡明道. 腹腔镜胆囊切除术意外发现早期胆囊癌的诊治进展. 腹腔镜外科杂志. 2018(02): 156-158 .
    16. 蔡文明. 腹腔镜胆囊切除术与根治性胆囊切除术治疗早期胆囊癌的效果比较研究. 临床合理用药杂志. 2018(18): 140-141 .
    17. 王官成. 扩大根治术对Nevin Ⅳ期胆囊癌的临床价值. 中国现代普通外科进展. 2018(03): 207-208 .
    18. 田佳,蔡兵,顾澄宇,安方梅. 意外胆囊癌的外科诊治现状. 中华全科医学. 2018(07): 1179-1182+1219 .
    19. 白燕南,吴嘉艺,洪嘉明,王耀东. Ⅱ~Ⅳ期胆囊癌患者行根治性切除的近远期疗效观察. 中外医学研究. 2018(35): 1-3 .
    20. 陈善鹏,王智翔,张小弟,魏志力,田伟. 胆囊原发性恶性黑色素瘤1例报告. 临床肝胆病杂志. 2017(09): 1782-1783 . 本站查看
    21. 毛晓明,陈方章,谭定勇,杨毅. 根治性切除术与单纯胆囊切除术治疗II期胆囊癌的临床疗效对比. 现代诊断与治疗. 2017(04): 720-721 .

    Other cited types(7)

  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Article Metrics

    Article views (2673) PDF downloads(437) Cited by(28)
    Proportional views
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return