检索历史 清除

胆囊癌是胆道系统常见的恶性肿瘤,临床上腹腔镜胆囊切除术得到广泛普及,但腹腔镜技术是否适合进行根治性切除尚存在争议.对于Tis期和T1a期的意外胆囊癌,单纯腹腔镜胆囊切除术后可以获得满意的5年生存率.腹腔镜探查能够辨别出影像学检查难以发现的微小的播散病灶,采用分期腹腔镜探查还可避免55.9%的不可切除胆囊癌患者接受不必要的开腹探查手术.但腹腔镜技术在胆囊癌根治术中的应用尚有争议.一般认为,腹腔镜技术在胆囊癌治疗中的争议主要包括两点:(1)腹腔镜手术是否会增加切口种植及腹腔转移的风险;(2)腹腔镜下能否完成复杂的肝脏切除并获得满意的淋巴结清扫效果.尽管对于经验丰富的微创肝胆外科医师来说,腹腔镜胆囊癌根治手术在技术上是可行的,但其长期预后方面尚需高质量前瞻性的大宗病例的临床研究加以论证.

This article introduces the current status and controversy of laparoscopic technique in the treatment of gallbladder carcinoma. Combined with the characteristics of incidental gallbladder carcinoma, the feasibility of laparoscopic techniques for the treatment of early gallbladder carcinoma is analyzed.In the era of minimally invasive medical,laparoscopic techniques should play a more important role in the management of gallbladder cancer, but the long?term prognosis of laparoscopic radical surgery for gallbladder cancer needs strict prospective and high?volume clinical research to validate.