The Early Diagnosis And Surgical Treatment In Primary Carcinoma Of The Gallbladder: A Report Of 62 Cases

objective To investigate the early diagnosis methods and the correlation between prognosis and surgical management and Nevin's stage in patients of primary carcinoma of gallbladderMethods The clinical data of 62 patients with gallbladder carcinoma from January 1993 to Decembe 2003 were analysed.Results Sixt-two cases admitted into our hospital from January 1993 to December 2003 were followed up.Diagnosis was confirmed Pathologically in all cases,among them 37 were female and 25 male.The age ranged from31 to 85 years old with a mean of 58.4.Sixt-nine percent of the Patients were associated with gallstones. Right upper quadrant pain and Jaundice were their major clinical manifestations . The preoperative diagnosis rate was 88.71%,in which only 11 cases were of early diagnosis the carcinoma(12.5%). The preoperative diagnosis rate of B-ultrasound was 72.58% . Gallbladder cancer with gallbladder stone was occurred in 69.35%. Pathology revealed adenocarcinoma in 82.25% of the cases. There was tumour removal in 38 cases, the rate was 61.29%,Nevin's stage I 4 cases ,II 7 cases III 27 cases,IV 10 cases , V 14 cases. The mean survival date of the 11 cases of Nevin's stage I and II was more than 5 years , of which one case 9 years ,The cases of Nevin's III- IV stages carcinoma received radical cholecystectomy, the mean survival date was 23 months , the cases of Nevin V carcinma received palliative cholecystectomy 6 months , undergoing a mere laparotomy 3 months.Conclusion Early diagnosis is the crucial factor for increasing successful treatment rate. B-ultrasound should be regarded as primary choice for diagnosis of gallbladder carcinoma.. It is a basic way for early diagnosis and improving prognosis to rationalize application of all kinds of examination means in PGC. According to the different stages of cancer, different operation methods such as radical operation or palliative cholecystectomy can be adopted.