探讨腹腔镜根治术治疗原发性胆囊癌的近期疗效及生存分析。

回顾性分析2015年10月至2016年10月83例原发性胆囊癌患者临床资料，根据术式不同分为单纯组(39例)和根治组(44例)。单纯组患者接受单纯腹腔镜胆囊切除术，根治组接受腹腔镜根治术治疗。采用SPSS 23.0统计分析软件，手术相关指标、中位生存时间以(±s)表示，两组间比较采用独立样本t检验，组内采用配对t检验；并发症、复发率、生存率以率表示，两组间比较采用χ²检验，采用生存函数Kaplan-meier检验分析并比较两组无进展生存期。

根治组手术时间比单纯组长(P<0.05)；两组术中出血量、首次下床时间、肛门排气时间、住院时间差异无统计学意义(P>0.05)。根治组术后1年、3年生存率为(77.3%、47.7%)均比单纯组(56.4%、25.6%)高(P<0.05)。根治组术后1年复发率为(2.3%)低于单纯组(17.9%)P<0.05。两组术后1年并发症总发生率差异无统计学意义(P>0.05)。单纯组患者术后3年内中位生存时间为(21.0±1.8)个月低于根治组患者为(25.9±1.6)个月，差异有统计学意义(t＝13.1309, P＝0.0000)。

腹腔镜根治术治疗原发性胆囊癌可有效提高Ⅱ期患者近期疗效，降低术后复发率，提高患者生存率，且安全性较高。

To investigate the short-term clinical outcome and survival analysis of laparoscopic radical cholecystectomy for primary gallbladder cancer.

Retrospective analysis were performed in 83 cases with primary gallbladder cancer from October 2015 to October 2016. According to different surgical methods, the patients were divided into simple group (39 cases) and radical group (44 cases). Patients in the simple group underwent laparoscopic cholecystectomy alone, and patients in the radical group underwent laparoscopic radical cholecystectomy. Statistical analysis were performed by using SPSS 23.0 software. Measurement data, such as operation-related indexes and median survival time were expressed as . Independent sample t test was used for comparison between the two groups, and paired t test was used for comparison within the group. Complications, recurrence rate and survival rate were expressed as rates. Chi square test was used for comparison between the two groups, Kaplan-Meier method was used to compare the progression-free survival of the two groups. P<0.05 was considered as statistically significant difference.

The operation time in the radical group were more than those in simple group (P<0.05). There was no significant difference in terms of blood loss, first bed time, anal exhaust time, and length of hospital stay between the two groups (P>0.05). The 1-year and 3-year survival rates (77.3% and 47.7%) in the radical group were higher than those in the simple group (56.4% and 25.6%) respectively (P<0.05). The one-year recurrence rate of 2.3% in the radical group was lower than 17.9% in the simple group(P<0.05). There was no significant difference between the two groups in terms of the total incidence of postoperative complications (P>0.05). The median survival time of patients in the simple group within 3 years after operation was (21.0±1.8) months, which was lower than (25.9±1.6) months of patients in the radical group, with statistically significant difference (t=13.1309, P=0.0000).

Laparoscopic radical cholecystectomy in the treatment of primary gallbladder cancer could effectively improve the short-term clinical outcome of patients with stage Ⅱ primary gallbladder cancer, reduce the recurrence rate after surgery, and improve the survival with higher safety.