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膽囊|這個被國外指南淘汰十幾年的手術，終于被踢出中國專家共識( 四 )


膽囊癌是一種侵襲性很強的惡性腫瘤，大部分患者一發現就是中晚期，死亡率很高, 五年生存率不足 5%。許多醫生和患者往往低估了膽囊癌的兇險 。張永杰教授告訴丁香園：「我遇到過最年輕的膽囊癌患者只有 18 歲 ?！?br /> 除了以上的醫學討論，許多醫生考慮到醫療責任等法律因素，對于無癥狀膽結石患者是否手術，仍交給患者自行決定 。
孫繩墨醫生表示「目前對患者的治療建議通常遵循第九版《外科學》上建議的手術指征 。對于無癥狀膽囊結石患者，手術指征為『結石數量多或者≥2到3cm，膽囊壁鈣化或者瓷性膽囊，膽囊息肉≥1cm，膽囊壁增厚≥3mm 。』建議手術，其余隨診觀察 ?！?br /> 「在制定《共識》的討論中，許多專家深知這一條手術指征一定會引起爭議，但仍然堅持將它提出來，希望引起大家警惕，因為這關系到很多患者的生命 ?！箯堄澜芙淌趯Χ∠銏@表示 ?；谶@個原因，最終并沒有將其命名為「指南」而是「共識」，歡迎更多醫生關注并加入討論 。（策劃：自如、gyouza）
題圖來源：圖蟲創意
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【膽囊|這個被國外指南淘汰十幾年的手術，終于被踢出中國專家共識】16. LESLIE J. SCHOENFIELD, M.D., Ph.D; JOHN M. LACHIN, Sc.D.; THE STEERING COMMITTEE (RICHARD A. BAUM, M.D.; ROBERT L HABIG, Ph.D.et al. Chenodiol (Chenodeoxycholic Acid) for Dissolution of Gallstones: The National Cooperative Gallstone Study. Ann Intern Med. 1982;97(3):391-398.