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項次 書目
1
題名:原發性膽囊癌的臨床分析    
Clinical Analysis of the Primary Gallbladder Cancer
著者:陳志仁(Chih-Jen Chen) ;王蒼恩(Tsang-En Wang) ;張文熊(Wen-Hsiung Chang) ;林錫泉(Shee-Chan Lin) ;白明忠(Ming-Jong Bair) ;李晉賢(Chin-Hsien Lee)
出版地區:台灣
出版城市:台北市
學科:醫學綜合
關鍵字:膽囊癌 ; 膽囊切除 ; Gallbladder cancer ; Cholecystectomy
刊名:中華民國癌症醫學會雜誌
頁碼:60-66
語言:繁體中文
摘要: 中文摘要PDF ; 英文摘要PDF

原發性膽囊癌是預後極差的消化道癌症,不僅難以早期發現,對於治療的反應也不盡理想。有鑑於此,我們回溯性分析本院原發性膽囊癌病例,就其臨床症狀、術前與術後之診斷差異、手術方式及多種影響預後因子進行討論。馬偕紀念醫院自1984年1月至2003年12月共20年期間,病歷記錄為膽囊癌共計73例,其中包括本院台北院區66例及台東院區7例。56例接受手術。術後平均追蹤時間為18.4個月,其中11例因無法追蹤而排除,總計45例納入分析。女性病患有24位而男性有21位。病患的平均年齡為67歲。有5例接受腹腔鏡膽囊切除術;而有33人接受剖腹式膽囊切除術。臨床症狀以腹痛,包括右上腹痛及上腹痛所佔的比例最多,約有86.7%。腫瘤指標則以CA19-9過高最多,依序為CEA與α FP。術前診斷工具以電腦斷層最多,佔40%,依序為腹部超音波33.3%以及逆行性膽道攝影11.1%。疾病分期與存活時間之間呈逆相關:相對於後期膽囊癌(第四、五期)之遠處轉移,腫瘤局限於膽囊壁內(第一、二、三期)有較佳的存活率(p<0.002))。早期診斷與積極治療是對抗原發性膽囊癌的兩大利器,藉由廣泛的文獻回顧,我們希望更瞭解這個疾病的病程及相關因子,並進而擬出有效積極的治療計畫。
Prognosis of primary gallbladder cancer is very poor. It is not only hard to diagnose in the early stage, but also responds poorly to treatment. We have retrospectively analyzed and discussed the cases of primary gallbladder cancer at our hospital, including the clinical presentation, the pre-and post-operative diagnoses, the methods of surgery and the outcomes. From January 1984 to December 2003, 73 patients were diagnosed with gallbladder cancer, including 7 cases from our Taitung branch hospital. Fifty-six cases received operation. The patients were followed for an average of 18 months postoperatively. Of these, 45 cases were analyzed. Twenty-four patients were female and 21 were male. The average age was 67 years. Five cases underwent laparoscopic cholecystectomy and 33 received open cholecystectomy. The clinical presentation was predominantly right upper quadrant pain and epigastric pain, seen in 86.7% of patients. CA19-9 was the tumor marker most frequently elevated, followed by CEA and α FP. Diagnosis was most frequently based on computed tomography (40%), followed by abdominal ultrasonography (33.3%) and endoscopic retrograde cholangiopancreaticosocpy (11.1%). Disease stage and survival time were inversely correlated. Tumors located within the gallbladder wall (stage Ⅰ~Ⅲ) had a better prognosis when compared with late stage tumors ( stage Ⅳ~Ⅴ) (p<0.002). It is our goal to learn more about the disease course and related prognostic factors through extensive literature review and thereby offer aggressive treatment plans.


    

本卷期目次
中華民國癌症醫學會雜誌
Treatment Outcome in Oropharyngeal Carcinoma-Preliminary Report/ Chih-Yung YangYi-Shing LeuJehn-Chuan LeeYi-Fang ChangMin-Jer HuangYu-Jen ChenHong-Wen ChenHung-Tao HsiaoChung-Ji Liu
Carcinoid Tumors of the Appendix-Experience in a Teaching Hospital/ Jiunn-Chang LinTsang-Pai LiuJee-Jen LeeChien-Liang LiuTsen-Long Yang
Transanal Local Excision of Rectal Malignant Neoplasms/ Wai-Hung LeungMing-Jen Chen
Local Anesthesia to Improve Postoperative Outcome for Breast Cancer Surgery: Preliminary Results/ Chung-Hsin TsaiYung-Wei HsuShih-Ping ChengChien-Liang LiuTsen-Long YangChun-Yueh LinYuan-Ching Chang
電腦刀立體定位放射性手術於治療第一型及第二型聽神經腫瘤之研究/ 林乾閔蔡若婷林牧熹林家瑋蘇鈺凱柯宗伯魏立邱文達張丞圭葉宜憲
家族性甲狀腺癌/ 鄭世平楊圳隆鄭國祥劉建良李居仁劉滄柏
影響臺灣地區非安寧照顧下進展性癌症病患認知預後的因素/ 陳貞秀劉莉妮徐翠霞蔣曉文雷靜怡唐秀治
原發性膽囊癌的臨床分析/ 陳志仁王蒼恩張文熊林錫泉白明忠李晉賢
A Case of Gastrointestinal Stromal Tumor (GIST) of Jejunum Presenting as Hollow Organ Perforation/ Shu-Hong ChuangHung-Bun LamChien-Liang Liu
A Disappearing Splenic Tumor on CT and MRI-A Case Report of Splenic Hamartoma/ Ming-Feng TsaiFei-Shih YangTsang-Pai LiuBe-Fong ChenTsang-En WangChien-Liang Liu
 
   
 
   

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