原文章：一步一步的决策实现肿瘤可接受，但避免过度侵入胆囊癌手术。

IF 2.7 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Hpb Pub Date : 2025-02-01 DOI:10.1016/j.hpb.2024.10.014

Kyoji Ito, Yoshikuni Kawaguchi, Yujiro Nishioka, Akinori Miyata, Akihiko Ichida, Nobuhisa Akamatsu, Norihiro Kokudo, Kiyoshi Hasegawa

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引用次数: 0

摘要

背景：胆囊癌是一种预后非常差的恶性肿瘤，需要最佳的手术策略才能达到有效的预后。我们的目的是评估基于图像t因子和胆囊癌切除术患者区域淋巴结转移和胆管残端术中病理的基于算法的决策方法的结果。方法：回顾了2001年4月至2022年6月期间接受胆囊癌切除术的患者的前瞻性数据库。我们的方法包括根据图像t因子和术中快速病理诊断来决定局部淋巴结清扫的程度。根据术中快速病理诊断胆囊残端或胆管残端，决定是否需要行额外胆管切除。结果：总体而言，148名患者接受了胆囊癌切除术，并评估了基于机构算法的手术策略的有效性。肿瘤可接受手术率在淋巴结清扫程度和胆管切除程度上分别为98.6%和96.9%。结论：我们基于图像t因子和术中病理的一步一步的决策方法可以有效地实现肿瘤可接受的胆囊癌切除术。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Original articles: step-by-step decision-making for achieving oncologically acceptable but avoiding over-invasive surgery for gallbladder cancer

Background

Gallbladder cancer is a malignancy with a highly dismal prognosis, requiring optimal surgical strategies to achieve effective outcomes. We aimed to evaluate the outcomes of our algorithm-based decision-making approach based on image T-factors and intraoperative pathology of regional lymph node metastases and the bile duct stumps in patients undergoing gallbladder cancer resection.

Methods

A prospectively maintained database of patients who underwent gallbladder cancer resection between April 2001 and June 2022 was reviewed. Our approach included the decision on the extent of local lymph node dissection based on image T-factors and intraoperative rapid pathological diagnosis. The need for extra bile duct resection was decided according to the intraoperative rapid pathological diagnosis of the cystic or bile duct stump.

Results

Overall, 148 patients underwent gallbladder cancer resection and were assessed to evaluate the efficacy of an institutional algorithm-based surgical strategy. Oncologically acceptable surgery rate was 98.6 and 96.9 % in terms of decision-making on the extents of lymph node dissection and bile duct resection, respectively.

Conclusion

Our step-by-step decision-making approach based on image T-factors and intraoperative pathology for gallbladder cancer resection was effective in achieving oncologically acceptable surgeries.

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来源期刊

Hpb GASTROENTEROLOGY & HEPATOLOGY-SURGERY

CiteScore

5.60

自引率

3.40%

发文量

244

审稿时长

57 days

期刊介绍： HPB is an international forum for clinical, scientific and educational communication. Twelve issues a year bring the reader leading articles, expert reviews, original articles, images, editorials, and reader correspondence encompassing all aspects of benign and malignant hepatobiliary disease and its management. HPB features relevant aspects of clinical and translational research and practice. Specific areas of interest include HPB diseases encountered globally by clinical practitioners in this specialist field of gastrointestinal surgery. The journal addresses the challenges faced in the management of cancer involving the liver, biliary system and pancreas. While surgical oncology represents a large part of HPB practice, submission of manuscripts relating to liver and pancreas transplantation, the treatment of benign conditions such as acute and chronic pancreatitis, and those relating to hepatobiliary infection and inflammation are also welcomed. There will be a focus on developing a multidisciplinary approach to diagnosis and treatment with endoscopic and laparoscopic approaches, radiological interventions and surgical techniques being strongly represented. HPB welcomes submission of manuscripts in all these areas and in scientific focused research that has clear clinical relevance to HPB surgical practice. HPB aims to help its readers - surgeons, physicians, radiologists and basic scientists - to develop their knowledge and practice. HPB will be of interest to specialists involved in the management of hepatobiliary and pancreatic disease however will also inform those working in related fields. Abstracted and Indexed in: MEDLINE® EMBASE PubMed Science Citation Index Expanded Academic Search (EBSCO) HPB is owned by the International Hepato-Pancreato-Biliary Association (IHPBA) and is also the official Journal of the American Hepato-Pancreato-Biliary Association (AHPBA), the Asian-Pacific Hepato Pancreatic Biliary Association (A-PHPBA) and the European-African Hepato-Pancreatic Biliary Association (E-AHPBA).