Analysis On 65 Cases Of Primary Carcinoma Of The Gallbladder (PCG)

Objective:To analyze the clinical characteristics of the primary carcinoma of the gallbladder(PCG),and discuss the clinical diagnosis, surgical options and prognosis.Methods:A retrospective analysis was performed for 65 cases of the primary carcinoma of the gallbladder,who received treatment from 2002.1 to 2008.4 in Xiangya Hospital Central South University.Results:65 patients were pathologic diagnosed,21 of them were male and 44 of them were female,male to female ratio 1:2.1,the oldest was 77 years old and the youngest was 34 years old,the average age was 57.9.The preoperative localization accuracy of B-ultrasonography (B-us) and computed tomography(CT) was 66.15%(43/65) and 87.18%(34/39).There was a significant difference between B-us and CT examinations for PCG(p<0.025).All 65 patients underwent operation treatment:5 patients performed cholecystectomy alone;13 patients performed radical surgery;8 performed extended radical gallbladder surgery;12 patients performed palliative resection + biliary drainage outside;4 patients performed palliative resection of gallbladder drainage; 10 patients performed biopsy + outside line drainage;1 performed pancreaticoduodenectomy;another 12 cases performed tumor biopsy only.Pathological types:54 cases of adenocarcinoma(83%),7 cases of mucinous adenocarcinoma,2 cases of squamous cell carcinoma,2 cases of adenosquamous carcinoma.Pathological stage(in accordance with the International Union Against Cancer(UICC) released TNM staging criteria):0 stage of 1 case,â… stage of 7 cases,â…¡stage of 6 cases,â…¢stage of 12 cases,â…£stage 39 cases.48 of the 65 patients have been followed-up,follow-up rate of 73.85%(48/65).1 cases of patients with 0 stage has not been followed-up;5 patients withâ… stage have been followed-up,including two cases of survival of 1 year,3 cases have survived 5 years;5 patients withâ…¡stage have been followed-up,two cases of survival of 1 year,2 cases survived for 2 years,1 cases of survival 5 years;11 patients withâ…¢stage have been followed-up,3 cases of survival of 1 year,2 cases survived for 2 years,1 case survival of 5 years,5 cases dead in one year;27 patients withâ…£stage have been followed-up,5 cases of survival of 1 year,2 cases survived for 2 years,1 cases of survival 3 years,19 cases dead in one year.The overall 1-year survival rate 50%(24/48),5-year survival rate 10.4%(5/48).Conclusions:B-ultrasonography and CT should be routine examination for preoperative,CT diagnosis of ultra-high positive rate than B-us.The clinical staging of gallbladder cancer affecting the prognosis.For a part of conditional cases ofâ…¢,â…£stage,should be performed extended radical gallbladder surgery,can improve survival rate;For patients with unsuspected gallbladder carcinoma,the positive line should be re-operation.