A 10-year experience in the management of gallbladder cancer
G C S Smith1, R W Parks, K K Madhavan
1Department of Clinical and Surgical Sciences (Surgery), Royal Infirmary of Edinburgh, Edinburgh, UK.
Background:
The aim of this retrospective study was to review all patients diagnosed with gallbladder cancer over a 10-year period to assess variables affecting survival.
Methods:
Patients diagnosed with gallbladder cancer from January 1990 to December 1999 were identified from the Lothian Surgical Audit database and a case-note review was performed.
Results:
The 44 patients who were studied (33 women, 11 men) had a mean age of 66 years (range 42-90 years). The diagnosis was established preoperatively in 25 patients (57%), intraoperatively in 5 patients (11%) and incidentally following pathological examination of cholecystectomy specimens in 14 patients (32%). None of the 25 patients diagnosed preoperatively underwent curative operations (median survival 4 months). All five patients diagnosed at the time of attempted cholecystectomy had advanced irresectable disease (median survival 1 month). The overall median survival in 14 patients with an incidental diagnosis of gallbladder cancer was 16 months; however, in eight of these patients who were considered to have had a potentially curative resection, the median survival was 38 months.
Discussion:
The prognosis for patients diagnosed preoperatively or at the time of cholecystectomy is very poor. Patients with an incidental finding of gallbladder cancer have a significantly better prognosis and should be considered for further radical re-resection.
