目的 探討瓷化膽囊經(jīng)腹腔鏡切除治療的可行性。
方法 對(duì)2006~2008年期間在中國(guó)醫(yī)科大學(xué)附屬第四醫(yī)院及附屬盛京醫(yī)院住院并手術(shù)治療的24例瓷化膽囊患者中經(jīng)腹腔鏡膽囊切除治療的13例患者的臨床資料進(jìn)行分析。
結(jié)果 24例瓷化膽囊患者占同期住院行膽囊切除術(shù)患者的0.48%(24/4964),術(shù)前超聲診斷陽性率為87.50%(21/24),其中13例瓷化膽囊患者經(jīng)腹腔鏡治療,均臨床治愈,1例術(shù)后發(fā)生漏膽,2例合并有膽囊癌的病例隨訪12及14個(gè)月未見切口腫瘤種植及轉(zhuǎn)移。
結(jié)論 瓷化膽囊在超聲影像學(xué)方面有特殊性表現(xiàn),選擇腹腔鏡膽囊切除手術(shù)治療是可行的,術(shù)中應(yīng)常規(guī)做冰凍病理檢查。
引用本文: 林琳,金俊哲,梁健. 13例瓷化膽囊的腹腔鏡治療. 中國(guó)普外基礎(chǔ)與臨床雜志, 2009, 16(9): 745-747. doi: 復(fù)制
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2. | Kane RA, Jacobs R, Katz J, et al. Porcelain gallbladder: ultrasound and CT appearance [J]. Radiology, 1984; 152(1): 137-141. |
3. | Towfigh S, McFadden DW, Cortina GR, et al. Porcelain ga-llbladder is not associated with gallbladder carcinoma [J]. Am Surg, 2001; 67(1): 7-10. |
4. | Kwon AH, Inui H, Matsui Y, et al. Laparoscopic cholecystectomy in patients with porcelain gallbladder based on the preoperative ultrasound findings [J]. Hepatogastroenterology, 2004; 51(58): 950-953. |
5. | Freund MC. Images in clinical medicine: porcelain gallbladder [J]. N Engl J Med, 1994; 330(26): 1906. |
6. | Stephen AE, Berger DL. Carcinoma in the porcelain gallbladder: a relationship revisited [J]. Surgery, 2001; 129(6): 699-703. |
7. | Lacaine F. Is the laparoscopic approach appropriate for porcelain gallbladder? [J]. J Chir (Paris), 2003; 140(2): 115-119. |
8. | 宋錄金, 鄧雅莉, 李莎, 等. 腹腔鏡膽囊切除中轉(zhuǎn)326例分析 [J]. 中國(guó)普通外科雜志, 1998; 7(3): 146-148. |
9. | 羅書畫, 馬俊, 黃中力, 等. 膽總管窗的臨床研究 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2009; 16(3): 215-217. |
10. | 印慨, 鄭成竹, 胡旭光, 等. 瓷化樣膽囊的腹腔鏡切除技術(shù)探討 [J]. 腹腔鏡外科雜志, 2005; 10(5): 297-298. |
11. | 孫登群, 龔仁華, 王敬民, 等. 腹腔鏡膽囊切除術(shù)后表現(xiàn)不典型膽瘺的原因及防治 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2009; 15(4): 278-280. |
12. | 沈柏用, 鄭民華, 李宏為, 等. 腹腔鏡膽囊切除術(shù)中肝中靜脈損傷的危險(xiǎn)性分析 [J]. 中華外科雜志, 2002; 40(1): 36-40. |
13. | Puia IC, Vlad L, Iancu C, et al. Laparoscopic cholecystectomy for porcelain gallbladder [J]. Chirurgia (Bucur), 2005; 100(2): 187-189. |
14. | Kuroki T, Tajima Y, Matsuzaki S, et al. Pre- and intraoperative evaluation of biliary system for successful laparoscopic cholecystectomy in porcelain gallbladder patients [J]. Hepatogastroenterology, 2002; 49(45): 621-624. |
15. | Aoki Y, Shimura H, Li H, et al. A model of port-site metastases of gallbladder cancer: the influence of peritoneal injury and its repair on abdominal wall metastases [J]. Surgery, 1999; 125(5): 553-559. |
16. | 范育林, 龔仁華, 徐正濤, 等. 腹腔鏡膽囊切除術(shù)意外膽囊癌28例報(bào)告 [J]. 中華微創(chuàng)外科雜志, 2008; 8(1): 35-36. |
17. | 段立紀(jì), 楊云江, 王存川, 等. 肝素及聚維酮碘預(yù)防穿刺孔轉(zhuǎn)移瘤的實(shí)驗(yàn)研究 [J]. 中華實(shí)驗(yàn)外科雜志, 2004; 21(6): 758. |
- 1. Elías Pollina J, Delgado Alvira R, Martínez-Pardo NG, et al. Must we change the surgical treatment of gallstones? [J]. Cir Pediatr, 2008; 21(2): 96-99.
- 2. Kane RA, Jacobs R, Katz J, et al. Porcelain gallbladder: ultrasound and CT appearance [J]. Radiology, 1984; 152(1): 137-141.
- 3. Towfigh S, McFadden DW, Cortina GR, et al. Porcelain ga-llbladder is not associated with gallbladder carcinoma [J]. Am Surg, 2001; 67(1): 7-10.
- 4. Kwon AH, Inui H, Matsui Y, et al. Laparoscopic cholecystectomy in patients with porcelain gallbladder based on the preoperative ultrasound findings [J]. Hepatogastroenterology, 2004; 51(58): 950-953.
- 5. Freund MC. Images in clinical medicine: porcelain gallbladder [J]. N Engl J Med, 1994; 330(26): 1906.
- 6. Stephen AE, Berger DL. Carcinoma in the porcelain gallbladder: a relationship revisited [J]. Surgery, 2001; 129(6): 699-703.
- 7. Lacaine F. Is the laparoscopic approach appropriate for porcelain gallbladder? [J]. J Chir (Paris), 2003; 140(2): 115-119.
- 8. 宋錄金, 鄧雅莉, 李莎, 等. 腹腔鏡膽囊切除中轉(zhuǎn)326例分析 [J]. 中國(guó)普通外科雜志, 1998; 7(3): 146-148.
- 9. 羅書畫, 馬俊, 黃中力, 等. 膽總管窗的臨床研究 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2009; 16(3): 215-217.
- 10. 印慨, 鄭成竹, 胡旭光, 等. 瓷化樣膽囊的腹腔鏡切除技術(shù)探討 [J]. 腹腔鏡外科雜志, 2005; 10(5): 297-298.
- 11. 孫登群, 龔仁華, 王敬民, 等. 腹腔鏡膽囊切除術(shù)后表現(xiàn)不典型膽瘺的原因及防治 [J]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2009; 15(4): 278-280.
- 12. 沈柏用, 鄭民華, 李宏為, 等. 腹腔鏡膽囊切除術(shù)中肝中靜脈損傷的危險(xiǎn)性分析 [J]. 中華外科雜志, 2002; 40(1): 36-40.
- 13. Puia IC, Vlad L, Iancu C, et al. Laparoscopic cholecystectomy for porcelain gallbladder [J]. Chirurgia (Bucur), 2005; 100(2): 187-189.
- 14. Kuroki T, Tajima Y, Matsuzaki S, et al. Pre- and intraoperative evaluation of biliary system for successful laparoscopic cholecystectomy in porcelain gallbladder patients [J]. Hepatogastroenterology, 2002; 49(45): 621-624.
- 15. Aoki Y, Shimura H, Li H, et al. A model of port-site metastases of gallbladder cancer: the influence of peritoneal injury and its repair on abdominal wall metastases [J]. Surgery, 1999; 125(5): 553-559.
- 16. 范育林, 龔仁華, 徐正濤, 等. 腹腔鏡膽囊切除術(shù)意外膽囊癌28例報(bào)告 [J]. 中華微創(chuàng)外科雜志, 2008; 8(1): 35-36.
- 17. 段立紀(jì), 楊云江, 王存川, 等. 肝素及聚維酮碘預(yù)防穿刺孔轉(zhuǎn)移瘤的實(shí)驗(yàn)研究 [J]. 中華實(shí)驗(yàn)外科雜志, 2004; 21(6): 758.