原发性胆囊癌是胆道系统常见的恶性肿瘤，早期无特异临床表现，一经发现多属中晚期，疗效不佳，预后极差。随着分子生物学与现代影像学技术的发展，近20年来，对胆囊癌的诊治水平虽有较大的提高，但总体上仍不能令人满意。
如何努力提高胆囊切除术的质量仍是极其重要的临床问题。随着腹腔镜胆囊切除术(LC)的广泛开展及胆道外科迈向微创手术时代的今日，胆囊残留病变的发生和危害依然存在，已成为胆道外科中不可忽视的问题。1 胆囊切除后的残留病变如残留胆囊、胆囊残端结石、胆囊管结石、残留胆囊颈部、胆囊管过长等，术后症状依然存在的患者，四处寻医，常常被戴上“胆囊切除术后综合征”的帽子，长期得不到有效的治疗，其中绝大多数都是因为胆囊切除术的质量问题需要进行有效的治疗，而不是胆囊切除术后综合征的问题。....................
Objective To study the effects of estrogen and progesterone and their receptors on the development of gallstone (GS) and primary gallbladder carcinoma (PGC), and probe to the relationship between the biological characteristic of PGC and female hormone and their receptors. Methods The study of PGC related to female hormone was reviewed by history document and experimental study in resently. Results The female hormone influenced human body extensively: they acted on not only the target organs, but also the nontarget organs with their receptors. The action was brought about by their receptors expression. The action intensity was dependent on not only the serum level of female hormone but also their corresponding receptors distributing in organs. The carcinogenic mechanism of estrogen was more clear with the discovery of estrogen-regulating-proteins. Conclusion The estrogen play an important role in the onset and development of GS and PGC. Estrogen and progestrone can inhance the patients′ susceptibility to the cholesterol gallstone and become a high risk factor in causing PGC through inducing their corresponding receptors expression in the gallbladder. Evaluating the effects of estrogen-estrogen receptor-estrogen-regulating-protein on biological characteristic of PGC is significant in guiding clinical endocrine treatment.
胆囊切除术(包括开腹胆囊切除术和腹腔镜胆囊切除术)是外科治疗胆囊良性疾病的标准术式，但是大约10%～30%的胆囊切除术患者会出现上腹或右上腹痛、餐后腹胀、消化不良、胆道感染或梗阻等临床症候群，发病时间从术后数周到数年，Pribram于1950年将上述症候群称为胆囊切除术后综合征(postcholecystectomy syndrome，PCS)，但何种原因导致上述症候群的出现未能明确［1］。随着影像学、内镜技术的发展，以及临床诊断技术的进步，特别是CT、MRI及磁共振胰胆管造影术(magnetic resonance cholangiopancreatography，MRCP)、内镜技术包括内镜超声(endoscopic ultrasound，EUS)和经内镜逆行性胰胆管造影术(endoscopic retrograde cholangiopancreatography，ERCP)的发展，绝大多数PCS患者能够明确病因并得到有效治疗。