Carcinoma of the Gallbladder – Current Surgical Treatment Options
Authors:
V. Třeška; T. Skalický; A. Sutnar; V. Liška
Authors‘ workplace:
Chirurgická klinika LF UK a FN v Plzni, přednosta: prof. MUDr. Vladislav Třeška, DrSc.
Published in:
Rozhl. Chir., 2008, roč. 87, č. 10, s. 503-506.
Category:
Monothematic special - Original
Overview
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
Sources
1. Lai, Ch., Lau, W. Y. Gallbladder cancer. – a comprehensive review. Surgeon, 2008, roč. 6, č. 2, s. 101–110.
2. Foster, J. M., Hoshi, H., Gibbs, J. F., Iyer, R., Javle, M., Chu, Q., Kuvshinoff, B. Gallbladder Cancer: Defining the Indications for Primary Radical Resection and Radical Re-resection. Ann. Surg. Oncol., 2007, roč. 14, č. 2, s. 833–840.
3. Misra, S., Chaturvedi, A., Misra, N. C. Carcinoma of the gall-bladder. Lancet Oncol., 2003, č. 4, s. 167–176.
4. Zissin, R., Osadchy, A., Shapiro-Feinberg, M. CT of a thickened-wall gallbladder. Br. J. Radiol., 2003, č. 76, s. 137–143.
5. Koh, T., Taniguchi, H., Yamaguchi, A. Differential diagnosis of gallbladder cancer using positron emission tomography with fluorine-18-labeled fluoro-deoxyglucose (FDG-PET). J. Surg. Oncol., 2003, č. 84, s. 74–81.
6. Yildirim, E., Celen, O., Gulben, K., Berberoglu, U. The surgical management of incidental gallbladder carcinoma. EJSO, 2005, č. 31, s. 45–52.
7. Cucinota, E., Lorenzini, C., Melita, G., Iapichino, G., Curro, G. Incidental gallbladder carcinoma: does the surgical approach influence the outcome? ANZ J. Surg., č. 75, s. 795–798.
8. Varshney, S., Buttirini, G, Gupta, R. Incidental carcinoma of the gallbladder. Eur. J. Surg. Oncol., 2002, č. 28, s. 4–10.
9. Pawlik, T. M., Gleisner, A. L., Vigano, L., Kooby, D. A., Bauer, T. W., Frilling, A., Adams, R. B. Incidence of Finding Residual Disease for Incidental Gallbladder Carcinoma: Implications for Re-resection. J. Gastrointest. Surg., 2007, č. 1, s. 1478–1487.
10. Wakai, T., Shirai, I., Yokoyama, N., Ajioka, Y., Watanabe, H., Hatakeyama, K. Depth of subserosal invasion predicts long-term survival after resection in patients with T2 gallbladder carcinoma. Ann. Surg. Oncol., 2003, č. 10, s. 447–454.
11. Shimada, Y., Yoshida, K., Tsukada, K. The role of lymph node dissection in treatment of gallbladder carcinoma. Cancer, 1997, č. 79, s. 892–899.
12. Shoup, M., Fong, Y. Surgical indications and extent of resection in gallbladder cancer. Surg. Oncol. Clin. North Am., 2002, č. 1, s. 985–994.
13. Garden, O. J. Hepatobiliary and Pancreatic Surgery. 1. vyd. Edinburgh: Elsevier Saunders, 2005, 385 s.
14. Goetze, T. O., Paolucci, V. Benefits of reoperations of T2 and more advanced incidental gallbladder carcinoma: analysis of German registry. An. Surg., 2008, roč. 247, č. 1, s.104–108.
15. Mekeel, K. L., Hemming, A. W. Surgical management of gall-bladder carcinoma: a review. J. Gastrointest. Surg., 2007, roč. 11, č. 9, s. 1188–1193.
16. Hezel, A. F., Zhu, A. X. Systemic therapy for biliary track cancers. Oncologist, 2008, roč. 13, č. 4, s. 415–423.
17. Ricardo, A. E., Feig, B. W., Ellis, L. M. Gallbladder cancer and trocar site recurrences. Am. J. Surg., 1997, č. 174, s. 619–623.
Labels
Surgery Orthopaedics Trauma surgeryArticle was published in
Perspectives in Surgery
2008 Issue 10
Most read in this issue
- Treatment Strategy in Non-Parasitic Benign Cysts of the Liver
- Carcinoma of the Gallbladder – Current Surgical Treatment Options
- Later Age Diaphragmatic Hernia
- Acute Scrotum is a Condition Requiring Surgical Intervention