Treatment and treatment of gallbladder

By | April 11, 2012

Gallbladder cancer treatment and treatment should be based on the principle of surgical treatment, but early detection of difficulties, most have reached the time of diagnosis of advanced, surgical resection for small, root resection can do less, only about 20%. Surgery on patients who can not adopt a comprehensive treatment, but the effect is very poor.
1. Gallbladder surgery are radical surgery and palliative surgery two categories.
1) The radical surgical treatment: lesions confined to the gallbladder is generally believed that around the adjacent organs, lymph node metastasis did not exceed the second leg of the gallbladder is to 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 the liver has been violated, the need to die, as the case form of liver resection of gallbladder or liver W, 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. Made thin gallbladder surgery gallbladder found as early as possible according to the aforementioned requirements of radical surgery, and 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.
2) palliative surgery: can cure the disease 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.
2. Non-surgical treatment of gallbladder cancer: radiation therapy to alleviate symptoms and prolong survival time may have a role, recent reports by foreign countries to improve intraoperative radiotherapy in patients with advanced gallbladder carcinoma pre-Ying and quality of life. Gallbladder is not sensitive to chemotherapy and more, the treatment results are poor, but I had to hepatic artery chemotherapy for the treatment of liver metastasis of the gallbladder, liver lesions found to be controlled, because of the limited number of cases, observation time is shorter, hard to be conclusive.
The treatment of gallbladder cancer and treatment, the current treatment of traditional Chinese medicine and immune effects of gallbladder uncertainty does not appear, the other purpose of symptomatic treatment of patients is restricted to relieve pain.

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