• 中國醫(yī)科大學附屬第四醫(yī)院肝膽外科(沈陽 110032);

目的  探討瓷化膽囊經(jīng)腹腔鏡切除治療的可行性。
方法  對2006~2008年期間在中國醫(yī)科大學附屬第四醫(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. 中國普外基礎(chǔ)與臨床雜志, 2009, 16(9): 745-747. doi: 復制

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例報告 [J]. 中華微創(chuàng)外科雜志, 2008; 8(1): 35-36.
17. 段立紀, 楊云江, 王存川, 等. 肝素及聚維酮碘預(yù)防穿刺孔轉(zhuǎn)移瘤的實驗研究 [J]. 中華實驗外科雜志, 2004; 21(6): 758.
  1. 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. 2. Kane RA, Jacobs R, Katz J, et al. Porcelain gallbladder: ultrasound and CT appearance [J]. Radiology, 1984; 152(1): 137-141.
  3. 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. 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. 5. Freund MC. Images in clinical medicine: porcelain gallbladder [J]. N Engl J Med, 1994; 330(26): 1906.
  6. 6. Stephen AE, Berger DL. Carcinoma in the porcelain gallbladder: a relationship revisited [J]. Surgery, 2001; 129(6): 699-703.
  7. 7. Lacaine F. Is the laparoscopic approach appropriate for porcelain gallbladder? [J]. J Chir (Paris), 2003; 140(2): 115-119.
  8. 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]. 中國普通外科雜志, 1998; 7(3): 146-148.
  9. 9. 羅書畫, 馬俊, 黃中力, 等. 膽總管窗的臨床研究 [J]. 中國普外基礎(chǔ)與臨床雜志, 2009; 16(3): 215-217.
  10. 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. 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]. 中國普外基礎(chǔ)與臨床雜志, 2009; 15(4): 278-280.
  12. 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性分析 [J]. 中華外科雜志, 2002; 40(1): 36-40.
  13. 13. Puia IC, Vlad L, Iancu C, et al. Laparoscopic cholecystectomy for porcelain gallbladder [J]. Chirurgia (Bucur), 2005; 100(2): 187-189.
  14. 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. 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. 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例報告 [J]. 中華微創(chuàng)外科雜志, 2008; 8(1): 35-36.
  17. 17. 段立紀, 楊云江, 王存川, 等. 肝素及聚維酮碘預(yù)防穿刺孔轉(zhuǎn)移瘤的實驗研究 [J]. 中華實驗外科雜志, 2004; 21(6): 758.