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  • br CEA and CA Abdominal CT scans

    2022-05-06

    
    (CEA and CA19-9). Abdominal CT scans were performed in patients with suspicious abdominal ultrasound findings. During the first 2 y, the patients were re-evaluated every 3 mo, and after 3 y, they were evaluated once every 6 mo. The follow-up time ranged from 2 to 93 mo, and the median follow-up time was 12 mo. Institutional approval was ob-tained for this study, and informed consent was obtained from all patients.
    Inclusion criteria and exclusion criteria
    The inclusion criteria were as follows: (1) pathological diag-nosis of GBC; (2) surgical treatment; and (3) complete clinical data.
    The exclusion criteria were as follows: (1) patients who underwent preoperative radiotherapy or chemotherapy; (2) patients with other malignant tumors; and (3) patients who underwent exploratory surgery.
    Surgical strategy and pathological features
    Of the 112 patients who were followed up, 25 patients were clearly diagnosed with GBC before surgery, 12 patients were diagnosed after surgery, and the other patients were clearly diagnosed by rapid pathological examination during surgery. Ten patients undergoing exploratory surgery were excluded from 112 patients. A total of 102 patients were included in the study. The pathological features are detailed in Table 1. The surgical methods are detailed in Table 2.
    Groups
    Patients were divided into a laparoscopy group and a lapa-rotomy group according to whether laparoscopic treatment was performed. The laparoscopy group included the following procedures: (1) LC without no PSB 1115 node dissection; (2) laparoscopic radical cholecystectomy (LRC) involving intra-operative resection of the gallbladder and wedge resection of the liver (at least 2 cm above the gallbladder bed) and skel-etonization of the hepatic duodenal ligament, namely, clearing of the cystic duct, the common bile duct lymph nodes and the proper hepatic artery lymph nodes; during surgery, the lymph nodes above the head of the pancreas were removed and examined by rapid pathology, and, if positive, the scope of the lymph node dissection was increased to include lymph nodes along the celiac trunk and lymph nodes at the head of the pancreas; furthermore, extrahepatic bile duct excision was determined based on incision of the cystic duct; and (3) laparoscopic-enlarged radical resection of GBC involving cholecystectomy and S4b þ S5 segmental resection of the liver or right hemihepatectomy and with an increased
    Table 1 e Comparison of pathological data of patients between laparoscopy group and laparotomy group.
    Variable Laparoscopy group (n ¼ 41) Laparotomy group (n ¼ 61) Statistic P value
    Lymph node metastasis
    T stage
    N stage
    Site of the tumor
    Body of gallbladder 25 30
    Neck of gallbladder 7 11
    Degree of tumor differentiation
    Pathological type
    Adenocarcinoma 24 53
    Squamous carcinoma 2 3
    Mixed cell carcinoma 1 1
    R0 margins
    Violation of the gland
    Note: 20 cases of patients who lost to follow-up and 10 cases of exploratory laparotomy were excluded. A total of 102 patients were included in the statistics.
    scope of lymph node dissection, with organ resection depending on the condition of the organ. The laparotomy group included the following procedures: (1) radical resection of GBC involving cholecystectomy combined with wedge resection of the liver (at least 2 cm above the gallbladder bed), hepatoduodenal ligament dissection and pancreatic head lymph node dissection; and (2) extended radical resection of GBC involving cholecystectomy combined with S4b þ S5 segmental resection of the liver or right hemihepatectomy and dissection of enlarged lymph nodes; organ resection was also performed depending on the condition of the organ.
    Statistical analysis
    Statistical analysis was performed with SPSS version 25.0 software. The measurement data were expressed as the mean SD. The PSB 1115 c2 test or Fisher’s exact test was used, as 
    appropriate, for categorical data. KaplaneMeier analysis was used to analyze the survival of the two groups. Tests of sur-vival rates were performed using the log-rank test. Statistical significance was defined as a P value < 0.05.
    Results
    Patients’ clinical and pathological data
    In Tables 1 and 3, the patients’ clinical and pathological data are detailed. There were three cases (7.3%) of postoperative complications in the laparoscopic group, including bile leakage and incisional infection. There were six cases (9.8%) of postoperative complications in the laparotomy group, including bile leakage, incision infection, and pleural effusion, and there was no significant difference between the two