Diagnosis and treatment of unsuspected gallbladder carcinoma / 第二军医大学学报

ABSTRACT

Objective: To summarize our experience on the diagnosis and treatment of unsuspected gallbladder carcinoma (UGC). Methods: The clinical data of 15 patients with AGC, who were treated in our hospital from January 2000 to December 2007, were retrospectively analyzed; and the clinical diagnosis and treatment experience was summarized. Results: Preoperative diagnosis showed that the 15 cases included gallstone in 12 cases, gallbladder polypi in 2, and gallstone associated with polypi in 1. All cases were incidentally discovered during operation, with 5 during open cholecystectomy and 10 during laparoscopic cholecystectomy. All 15 cases were confirmed of gallbladder carcinoma by pathological examination after operation. The tumor stage included Nevin stage I in 3 cases, stage II in 7, stage III in 4 and stage IV in 1. The patients with UGC at Nevin stage I were closely followed up; those at Nevin stage II, III underwent radical correction of gallbladder carcinoma; and those at Nevin stage IV received extended radical resection of gallbladder cancer. The median follow-up time was 5.0 years. Two patients died and 13 survived; 5 patients survived for more than 5 years, with a 5-year survival rate of 84.8%. Conclusion: It is difficult to diagnose early gallbladder carcinoma before operation. The surgeons should be alert to the possibility of gallbladder carcinoma before and during the operation. Routine examination of the resected gallbladder tissues and frozen sections are necessary for suspected lesions. Immediate radical resection is an effective measure to improve the prognosis of UGC. Re-exploration and radical resection should be performed on UGC of Nevin stage II-IV.