RESUMEN
Objective To investigate the treatment strategy for the re-operation patients with gallbladder cancer revealed by pathological results after laparoscopic cholecystectomy .Methods The clinical data in 15 cases of gallbladder cancer found by pa-thology after laparoscopic cholecystectomy in the general surgery department of this hospital during 2009-2013 were retrospective-ly analyzed .Results The pathological results on 3-5 d after laparoscopic cholecystectomy in 15 cases showed gallbladder cancer , tumor located at the gallbladder fundus in 2 cases ,the gallbladder body in 2 cases and gallbladder neck in 9 cases;there were 1 case of severe atypical hyperplasia ,2 cases of high differentiation adenocarcinoma ,9 cases of middle differentiation adenocarcinoma and 3 cases of low differentiation adenocarcinoma ;there were 1 case of Tis ,8 cases of pT Ⅰa ,6 cases of pTⅠb ,and 15 cases of bile tube incisal edge were negative .All 15 cases received re-laparotomy and hepatic duodenal ligament lymph nodes resection on 6-11 d af-ter cholecystectomy ,There were 1 case in the stage 0 ,8 cases in the stage Ⅰa ,5 cases in the stage Ⅰb ,1 case in the stage Ⅲb by TNM classification .The postoperative follow up lasted for 28 -79 months ,the accumulative survival rate was 100% in 1 year , 100% in 2 year ,93% in 3 year ,93% in 5 year .One case of stage Ⅲb was found repeated metastasis obstructive jaundice ,received transcutaneous puncture bile tract drainage and died after 3 months;no postoperative incision implantation metastasis was found . Conclusion Gallbladder cancer found by pathological examination after laparoscopic cholecystectomy is generally in early stage . Therefore ,early conducting the additional hepatic duodenal ligament lymphadenectomy has relatively good prognosis .
RESUMEN
Isolated tuberculosis of pancreas is very rare clinical entity. Since 1970, we have treated 9 patients, 3 men and 6 women (average 48.3 years), with isolated tuberculosis of pancreas. 2 patients were diagnosed as pancreatic tuberculosis, 1 patient pancreatic cyst and 6 patients pancreatic carcinoma before operation. They all underwent exploratory laparotomy, and were confirmed to be pancreatic tuberculosis by histopathology. Their common characteristics were that tuberculosis was only localized in pancreas without tuberculosis at extrapancreatic sites and that the treatment of anti-TB drugs had much effect on them. By analysis, it was considered that isolated tuberculosis of pancreas was usually mistaken for pancreatic carcinoma because it localized in pancreas, the contents of masses in pancreas should be noted carefully in order to avoid misdiagnosis and treatment of anti-TB drugs should be taken in time.