Primary Carcinoma of the Gall Bladder in University of Port Harcourt Teaching Hospital

ABSTRACT

Background: Carcinoma of the gall bladder [CaGB] is an uncommon but deadly cancer of the biliary tract Aim: To report experience in the management and the treatment outcome of patients managed for an uncommon tumour. Methods: Case notes of 215 patients who had gallbladder surgery between 1989 and 2009 in the Department of Surgery were retrieved. Demographic data; treatment and treatment outcome were retrieved from these case notes. Results: There were 18 cases of proven primary carcinoma of the gallbladder. There were 14 (77.8) females and 4 (22.2) males with a female/male ratio of 3.51. The patients aged between 52 and 70 years. The mean age at diagnosis was 61.3 years. The presenting symptoms were related to the associated gall stones and they are dyspepsia; anorexia; right hypochondrial pain; palpable gall bladder mass; weight loss; jaundice; pruritus; palpable liver and ascites. Five (27.8) cases were diagnosed correctly pre- operatively while 2 (11.1) cases with distended gall bladder were misdiagnosed as gastric outlet obstruction. Eleven (61.1) cases were diagnosed during surgery and were confirmed post operatively from the histopathological reports. Attempt at curative treatment was possible for only 8 (44.4) patients with early disease (stages I and II) .Fourteen cases (77.8) were well or moderately differentiated adenocarcinoma while 4 cases were undifferentiated adenocarcinoma and squamous cell carcinoma. Conclusion: From this report; we deduced that the treatment outcome of patients with gall bladder carcinoma is highly dependent on the stage of the tumour and the feasibility of a curative treatment