日本消化器病学会雑誌
Online ISSN : 1349-7693
Print ISSN : 0446-6586
胆のう癌, 特に早期の胆のう癌の臨床
大藤 正雄高沢 五郎小榑 規覚国安 芳夫黒田 健昭大野 孝則三木 亮税所 宏光熊谷 哲夫上野 高次
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1969 年 66 巻 2 号 p. 146-158

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Many authors report that the onset of carcinoma of the gallbladder is insidious and often reaches a advanced stage before it becomes clinically manifest as a malignant condition. But, the fact is well known that cholelithiasis often precedes and may be an etiological factor.
So, it is considered worth while for early diagnosis and treatment to clarify the clinical and pathological features of relatively early primaly carcinoma of the gallbladder.
Seventeen cases of carcinoma of the gallbladder were analyzed in detail for clinical and laboratory data and pathological results.
They were divided into the early carcinoma which had a better prognosis surviving for over three years after cholecystectomy, and the progressed carcinoma which had a worse prognosis dying within one year after the admission to hospital.
The early carcinoma was almost combined with gallstone and showed clinical signs and symptoms as chronic cholecystitis or cholelithiasis with a long clinical course for over two years, while the progressed carcinoma was combined with symptomless gallstone or without gallstone and showed clinical signes and symptoms as a malignant condition with a short clinical course for several months.
Among many clinical investigations, cholecystographic diagnosis was the most valuable for the early carcinoma.
From gross appearance of the mucous membrane surface, the early carcinoma was divided into the flatt, protuberant and hollowed type.
It could be considered that early primary carcinoma of the gallbladder to expect a relief by surgery show microscopically a localized infiltrtion to the mucosa and musculature without penetration through the muscular layer and no metastasis to lymph nodes and other organs.

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