摘要
目的:探讨Ⅳ期胆囊癌辅助化疗后，行机器人下胆囊癌根治性手术可行性及安全性。方法:回顾性分析1例经影像学评估Ⅳ期胆囊癌患者，采用吉西他滨＋奥沙利铂＋卡瑞利珠单抗辅助化疗后，肿瘤明显降期，遂行机器人下胆囊癌根治性手术，并复习相关文献进行讨论。结果:Ⅳ期胆囊癌患者，肿瘤明显降期后，成功实施机器人下胆囊癌根治术，手术时间265 min，术中出血量50 ml，术后住院时间6 d，无胆漏、出血、腹腔感染等相关并发症。术后病理证实胆囊中低分化腺癌，切缘均为阴性，切取淋巴结17枚，均为阴性。结论:Ⅳ期胆囊癌患者，采用有效化疗后，肿瘤降期，能够缩小手术切除范围，且采用机器人手术，完成肿瘤R0切除，有着手术安全、有效、创伤小、恢复快等特点，具有良好临床应用前景。
Abstract
Objective:To investigate the feasibility and safety of robotic-assisted radical cholecystectomy for the stage Ⅳ gallbladder cancer after adjuvant chemotherapy.Methods:A patient with the stage Ⅳ gallbladder cancer was retrospectively analyzed. After adjuvant chemotherapy with gemcitabine+ oxaliplatin+ carrilizumab, the stage of the gallbladder cancer was significantly reduced, and the robotic-assisted radical cholecystectomy was performed, and the relevant literature was reviewed.Results:The patients with the stage Ⅳ gallbladder cancer, after adjuvant chemotherapy, the robotic surgery was successfully performed. The operation time was 265 min, the intraoperative blood loss was 50 ml, the postoperative hospital stay was 6 days, and there were no related complications such as bile leakage, bleeding, abdominal infection. Postoperative pathology confirmed a gallbladder adenocarcinoma with negative margins and 17 lymph nodes were removed.Conclusion:The Ⅳ stage gallbladder cancer, with effective adjuvant chemotherapy, was resected with a small rang specimen and obtained R0. Robotic-assisted radical cholecystectomy has the characteristics of safe and effective surgery, less trauma and quick recovery, etc., and has clinical application prospects.
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