Gallbladder cancer Treatment
1. The principles of Gallbladder cancer (carcinoma of gallbladder) surgical treatment:
1) Radical surgery for Gallbladder cancer: when they seek medical treatment as a result of gallbladder cancer in patients often is not early stage, can be radical resection of gallbladder carcinoma accounts for only about 23 percent. Gallbladder in patients with overall median survival period of 3 months. In recent years, because of the gallbladder to carry out radical surgery, postoperative 5-year survival rate has improved significantly. The scope of radical surgery including cholecystectomy, partial hepatectomy and lymph node dissection. General removal of the liver around the gallbladder bed for about three centimeters. Lymph node dissection in accordance with its convergence of approaches and the transfer of the case may be. General clean-up to the next lymph node metastatic lymph nodes. As long as the early removal of the gallbladder gallbladder lymph nodes, but the majority of resectable liver dissection of the gallbladder should ligament lymph nodes, if necessary, cleaning should be pancreatoduodenectomy, the pancreatic lymph nodes.
2) Palliative surgery for advanced Gallbladder cancer: Can not cure with advanced gallbladder carcinoma, surgical principles in order to alleviate suffering, improve the quality of life. Advanced gallbladder problem is more prominent as a result of violations of biliary tract cancer caused by obstructive jaundice. Surgery should be considered for drainage. Methods of internal drainage of bile duct jejunum anastomosis, but often as a result of local tumor-infiltrating deeper, especially with hilar infiltration, and intestinal bile drainage often difficult to carry out. Of such patients, a viable bridge drainage. For the case of very poor general condition, but also possible outside the drainage tube. For hilar line can not be serious violations of the above-mentioned surgery, and curettage and aspiration can be right hepatic incision method to find the expansion of hepatic duct right hepatic order drainage lines.
2. Radiotherapy: only used as an adjunct to surgery. General radiation dose of 40 ~ 50GY. Intraoperative radiotherapy in resected lesions, the use of cyclotron produced by electron beam, to 20 ~ 30GY of radioactivity.
3. Chemotherapy: gallbladder for a variety of chemotherapy drugs are not sensitive, it is difficult to observe the efficacy of postoperative adjuvant therapy used. Drugs commonly used in ADM ,5-FU, MMC, etc.. (Vi) the prognosis of gallbladder carcinoma 5-year survival rate is very low, about 2% ~ 5%; 80% of patients died within 1 year. If only invasion of gallbladder mucosa and submucosa for laparoscopic cholecystectomy better the prognosis, it was reported that this group of patients 5-year survival rate of up to 40% ~ 64%. Therefore, the key is good or bad prognosis of early diagnosis and timely treatment.
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