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首页> 外文期刊>Surgical Endoscopy >Do complications related to laparoscopic cholecystectomy influence the prognosis of gallbladder cancer?
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Do complications related to laparoscopic cholecystectomy influence the prognosis of gallbladder cancer?

机译：腹腔镜胆囊切除术相关的并发症会影响胆囊癌的预后吗？

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BACKGROUND: Laparoscopy is thought to worsen the prognosis of gallbladder cancer (GBC) discovered unexpectedly at laparoscopic cholecystectomy (LC). However, laproscopy has never been shown to have an influence on patient survival in clinical series. METHODS: We Performed a two-center retrospective analysis of 28 patients with GBC (11 previously known, 17 unexpectedly discovered by LC) to determine whether laparoscopy and complications related to LC had any influence on the prognosis of GBC. Resectability for cure after LC, survival, and recurrence related to both the procedure itself and complications associated with LC were analyzed. RESULTS: Of the 17 patients with unexpected GBC, 16 were considered resectable for cure at the time of LC. Advanced disease was detected in eight patients by re staging (n = 5) or exploration (n = 3). Seven patients (43.8%) underwent reoperation for cure. Mean survival of patients with unexpected GBC was 26.5 months. Mean survival was shorter when complications (bile spillage, injury of common bile duct, or tumor violation) occurred during LC (10.2 vs 33 months, p = 0.016). If bile spillage was the only complication at LC, there was also a trend to shorter survival (12 vs 33 months, p = 0.061). CONCLUSION: Complications during LC significantly worsen the prognosis of GBC. Therefore, bile spillage and excessive manipulation of the gallbladder should be avoided.
机译：背景：腹腔镜检查被认为会使在腹腔镜胆囊切除术（LC）中意外发现的胆囊癌（GBC）的预后恶化。然而，从未在临床系列中证明腹腔镜检查对患者生存有影响。方法：我们对28例GBC患者（以前已知11例，LC意外发现17例）进行了两中心回顾性分析，以确定腹腔镜检查和与LC相关的并发症是否对GBC的预后有影响。分析了LC后的可切除性，生存率以及与手术本身以及与LC相关的并发症相关的复发率。结果：在17例意外的GBC患者中，有16例在LC时被认为可切除。通过重新分期（n = 5）或探索（n = 3）在八名患者中发现了晚期疾病。 7例（43.8％）接受了再次手术治愈。患有意外GBC的患者的平均生存期为26.5个月。 LC期间发生并发症（胆漏，胆总管损伤或肿瘤侵犯）时，平均生存期较短（10.2 vs 33个月，p = 0.016）。如果胆汁漏出是LC的唯一并发症，则还有生存期缩短的趋势（12 vs 33个月，p = 0.061）。结论：LC期间的并发症显着恶化了GBC的预后。因此，应避免胆汁溢出和对胆囊的过度操作。

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