在胆囊切除术中偶然发现的胆囊癌:外科手术期间的危险因素
Elizabeth J Olecki1,2, Mackenzie Mayhew3,4, Rolfy Perez Holguin3,4
1Department of Surgery, College of Medicine, The Pennsylvania State University, Hershey, PA, USA. eolecki@pennstatehealth.psu.edu.
Journal of gastrointestinal cancer
|January 9, 2024
概括
胆囊癌 (GBC) 经常在手术期间偶然发现. 识别年龄,性别,体重减轻和性酸酶升高等危险因素可以改善GBC的早期检测和手术规划.
科学领域:
- 在瘤学瘤学.
- 手术病理学手术病理学
- 流行病学 流行病学
背景情况:
- 胆囊癌 (GBC) 诊断通常在胆囊切除术后偶然发生,因为可能是良性疾病,往往需要更广泛的手术.
- 未定义的风险因素导致GBC诊断延迟,影响患者的治疗结果.
研究的目的:
- 确定与偶然发现的GBC相关的手术前和手术内因素.
- 增强手术前和手术内GBC的诊断能力.
主要方法:
- 美国外科医生学院国家外科质量改进计划数据库的分析 (2007-2017).
- 具有和没有偶然的GBC诊断的患者之间的人口统计学,手术内和术后特征的比较.
- 使用单变量和多变量逻辑回归分析.
主要成果:
- GBC的发生率为0.11%.
- 手术前GBC的风险因素包括年龄> 60,女性性别,体重减轻史,以及性酸酶升高.
- 开放式手术方法和更长的手术时间与GBC诊断有显著的关联.
结论:
- 偶然诊断出GBC的患者与良性胆囊病患者有所不同.
- 识别GBC预测因子允许针对性地进行手术前瘤评估.
- 术内冷病理学可以帮助诊断GBC.
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