E. Târcoveanu, D. Niculescu, C. Lupascu, Niculina Florea*, D.
Ferariu*, D. Negru**, Felicia Crumpei**, C. Volovat, N. Vlad, R. Moldovanu
First Surgical Clinic „I. Tanasescu-Vl. Butureanu” Iasi,
University of Medicine and Pharmacy Iasi
* Department of Morfopathology „St. Spiridon” Hospital
** Department of Radiology „St. Spiridon” Hospital Iasi
Jurnalul de chirurgie 2005; 1 (2):223-231
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Despite recent advances in diagnostic and surgical techniques, the
prognosis of gallbladder carcinoma remains poor. Only in early stage
gallbladder carcinoma (tumour limited to the mucosa or proper muscle
layer), a satisfactory outcome can be obtained by simple cholecystectomy
or cholecystectomy with regional lymph node dissection.
From 1996 to 2004, 46 patients with gallbladder carcinoma underwent
surgical procedures in our surgical unit (0,6% from all the cholecystectomies).
There were 8 male and 38 female with mean age of 66 yo.
Diagnosis was established preoperatively in only 5 cases (by abdominal
ultrasonography exam and CT-scan), during the surgical intervention
for 31 patients and postoperatively in 10 cases.
We performed 17 cholecystectomies (12 by laparoscopic approach),
7 cholecystectomies and hepatic resections, 8 cholecystectomies and
„T” tube drain into the common bile duct (for lithiasis),
6 anastomosis between choledocus and duodenum or jejun, 2 cholecystectomies
and drilling transtumoural stent and 6 other types of interventions.
We also performed 3 surgical re-interventions (2 hepatic resections
of the 4-th and 5-th segments and one limfadenectomy in the hepatic
pedicle - movie). Postoperative mortality in the first 10 days was
8.7% (4 cases). We also performed postoperative chimiotherapy in 28
cases. Conclusion: Gallbladder carcinoma has a poor prognosis.
Preoperative diagnosis is possible only in advanced stages. Laparoscopic
cholecystectomy has to indicated in early stages of biliary lithiasis.
Radical resection with lymphadenectomy is the best surgical treatment.
KEYWORDS: GALLBLADDER CARCINOMA, CHOLECYSTECTOMY, HEPATIC