Carcinoma of the Gallbladder – Current Surgical Treatment Options

Česká verzia

Authors: V. Třeška; T. Skalický; A. Sutnar; V. Liška
Authors place of work: Chirurgická klinika LF UK a FN v Plzni, přednosta: prof. MUDr. Vladislav Třeška, DrSc.
Published in the journal: Rozhl. Chir., 2008, roč. 87, č. 10, s. 503-506.
Category: Monothematic special - Original

Summary

Background:
The effect of radical resection in gallbladder cancer is still area of debate.

Aim of study:
To determine the criteria of surgery in primary and incidental gallbladder cancer.

Method:
Eighty-four patients with gallbladder cancer were evaluated between 1999 and 2008. Sixty patients (72.4%) were symptomatic. Explorative laparotomy was performed in 40 (66.7%), palliative procedure in 5 (8.3%) patients in stage pT3-4, N1, M0-1. Cholecystectomy only or completed with wedge resection of the gallbladder bed and lymfadenectomy as radical procedure was performed only in 7 (1.7%) patients in pT1-2, N0-1, M0. Twenty four (28.6%) patients had incidental gall bladder carcinoma. Radical cholecystectomy was performed in 4 (16.7%) – pT1a, N0, M0, palliative cholecystectomy in 3 patients (12.5%) – pT3, N1, M0. Radical reoperation was performed in 15 (62.5%) patients in stage pT1b-2, N0-1, M0.

Results:
Patients survival after explorative laparotomy and palliative procedures was no longer than 7 months. Four from seven patients died after radical operation 12–18 months after operation. Six from 15 radically re-operated patients are alive in interval 4 months and 8 years. Nine patients died in interval 9 months and 4 years after re-operation.

Conclusion:
Radical surgical procedure is the treatment of choice for patients with gall bladder carcinoma especially in stage pT1-2, N0, M0.

Key words:
gallbladder cancer – radical resection – reoperation

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