Jurnalul de Chirurgie
ISSN: 1584 - 9341
Vol.1 Nr.2 - aprilie - iunie 2005
 
     ENGLISH

  :

NUMARUL 2, VOL. 1, 2005

MULTIMEDIA

GALLBLADDER CARCINOMA
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 Iasi
** Department of Radiology „St. Spiridon” Hospital Iasi
Jurnalul de chirurgie 2005; 1 (2):223-231
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Abstract:

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 RESECTION

Correspondence: etarco@iasi.mednet.ro