첫 수술로 복강경 담낭절제술을 시행한 담낭암 환자에서의 예후 분석
Prognosis of patients with the gallbladder carcinoma undergone laparoscopic cholecystectomy as an initial operation
소속 상세정보
최상태/Choi ST
황신/이승규/이영주/박광민/김기훈/안철수/문덕복/Hwang S/Lee SG/Lee YJ/Park KM/Kim KH/Ahn CS/Moon DB
KMID : 0371320030650020140
Abstract
Purpose : Laparoscopic cholecystectomy (LC) has become a standard procedure for treatment of benign gallbladder diseases. There has been a small proportion of gallbladder cancers (GBC) which were incidentally found in the LC specimen, and LC has been tried in some patients with suspected GBC. This study intended to analyze the prognosis of patients with GBC undergone LC and the outcome of extended re-operation.
Methods : From Jan. 1995 to Aug. 2001, the outcome of 59 GBC patients undergone LC initially were analyzed. 100 GBC patients undergone laparotomic resection were chosen as control group. CO2 inflation method was used for LC.
Results : The depths of cancer invasion in 59 patients were as following: pT1s in 2 (3.4%), pT1a in 4 (6.8%), pT1b in 14 (23.7%), pT2 in 28 (47.5%), and pT3 in 11 (18.6%). Re-operation was carried out at average 14 days after LC in 25 (42%) patients. There was no recurrence in patients with pT1s and pT1a GBC, but there were two recurrent cases in pT1b GBC (each case with and without re-operation). The survival rate of patients of pT2 GBC who underwent re-operation after LC was better than that of patients who underwent one-stage laparotomic resection, but this difference was not demonstrated in patients with pT3 GBC.
Conclusion : We think that LC does not deteriorate the prognosis of patients with incidentally detected GBC if appropriate re-operation is carried out according to the cancer staging. However, there is some possibility of tumor cell spillage during LC, so laparotomy should be preferred to LC for patients with suspected GBC in preoperative assessment. (J Korean Surg Soc 2003;65:140-144)
키워드
Laparoscopic cholecystectomy; Gallbladder cancer; 복강경 담낭절제술; 담낭암
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