Gallbladder surgery

By | October 13, 2011

    Dan Nangai principle should be treated surgically, but because of difficulties in early detection, diagnosis Duoshu have reached middle and late surgical resection for small, less radical resection can do, only about 20%. Surgery on patients who can not adopt a comprehensive treatment, but the effect is very poor.
Common gallbladder surgery can be divided into radical surgery and palliative surgery two categories.
A common surgical treatment of gallbladder carcinoma, radical surgery is generally believed that lesions confined to adjacent organs surrounding the gallbladder, lymph node metastasis did not exceed the second leg of the gallbladder can cure, as the case may be a reasonable implementation of radical surgery.
(1) simple cholecystectomy: Tumor limited to mucosa or submucosal layer, especially more than papillary carcinoma, simple cholecystectomy is guilty radical, no lymph node dissection, the survival rate after five years, up to 64%.
(2) regional lymph node dissection: tumor invasion and gall bladder muscle and full layer or higher malignant mucinous adenocarcinoma and undifferentiated carcinoma have been associated with lymph node metastasis and more, shall within the hepatoduodenal ligament lymph nodes, common bile duct lower duodenum, lymph nodes and lymph nodes around the first film completely removed.
(3) partial resection of the liver: Where the lesion involved the whole layer of the gallbladder or has violated the liver, the need to die, as the case form of liver resection of gallbladder or liver IV, v segmental resection, is also scope for greater infiltration of the liver underwent right liver resection of the reports.
(4) extended radical resection of gallbladder cancer: tumor invasion of gastric antrum, duodenum or hepatic flexure of the colon will be en bloc resection of involved organs. Found in lean manufacturing gallbladder gallbladder surgery required by the aforementioned radical surgery as early as possible, and the abdominal wall sinus and surrounding tissues at the same time removed. There are reports on the implementation of the gallbladder bile duct and right hepatic gallbladder removal, cholecystectomy combined resection of duodenal membrane, duodenum, gallbladder removal right hepatic coated portal vein, hepatic artery resection and reconstruction, with its value and long-term efficacy need further evaluation.
Second, common gallbladder surgery, palliative surgery can cure diseases is beyond the scope of high-risk patients with severe gallbladder infection and other radical treatment should not be the case, to alleviate the symptoms of possible palliative cholecystectomy. Bile duct obstruction for the invasion, can be used endoscopic catheter, surgical tube, bridge internal drainage or biliary enteric drainage, etc. jaundice treatment. Those who can not eat with duodenal obstruction add discretion to do gastrojejunostomy. Less certain malignant, slow progress of cases, palliative surgery is expected to prolong survival and improve quality of life.

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