The Analysis Of Diagnosis And Treatment Of 135 Patients With Primary Gallbladder Cancer

Primary gallbladder carcinoma (PGC) is the common malignancy of the biliary tree ,and its incidence has been increasing in recent years.It is about the fifth to the sixth in all tumors of alimentary system, and of all the general surgery's patients ,its ratio is about 0.1%-1.1%,average 0.28%; 0.4%-3.8%, average 1.52% of all the biliary tract's diseases,But at present it is deficient in statistical analysis of a large number of clinical data. Because PGC is a high malignant cancer, and no typical symptoms and signs are available at its early stage,it is difficult to be diagnosed at early stage.Once detected ,most patients were in the advanced stage,and missed the best opportunity of therapy.In recent years.with the progress of Molecular biology and Radiology, the early diagnosis is improved,but is still not satisfactory.The 5-year survival is more than 90% in the ealy PGC after operation,but it's less than 5% in the advanced stage.Thus it is extremely important to improve early diagnosis of PGC for the better result of treatment. Of all the treatments for PGC, surgery is the most important method. The ratio 'of radical resection is only 20%-40%, and the extended resection is argumentative. To improve the early diagnosis and the treatment of PGC. 135 patients confirmed pathologically after operation in ourhospital form 1992 to 2001 were analyzed retrospectively, The ratio of man to woman was 54:81, form 34 to 89 years old ,with an average of 62.8 years. The BUS was given to 135 ,CT to70, MRCP to 25,and tumor markers were examined in 52 cases .simple cholecystectomy was performed in 15 cases, radical resection in 29,extended resection in 26, and palliative operation in 65, and 9 dead after operation because of complication. The rate of early diagnosis of PGC was 35.29% 11 missed diagnosis; the rate of successful operation was 50%;The median survival of the patients after radical operation was longer than those after palliative operation. The positive rate of BUS is 73.3%;CT is 75.7%; MRI(or MRCP) is 80%;CT and BUS is 93%.In conclusion, it is difficult to be diagnosed at the early stage of PGC;and we should use various examinations to improve early diagnosis of PGC; the ratio of operation in advanced patients was low, and extended resection was useful to improve the survival time of PGC.