Surgical Treatment For Gallbladder Carcinoma

Objective:To explore the relationship between Nevin atage,treatment and prognosis of gallbladder carcinoma,make a conclusion of the operative procedure choice.Methods:A retrospective clinical analysis was made in 42 patients with gallbladder carcinoma who had been diagnosed at our number 2 hospital affiliated at School of Medicine Zhejiang University,from 2005 Jan to 2007 Jun.Result:Of the 42 patients,16 were men and 26 women with a male to female ratio of 1:1.63.Their age ranged from 44 to 75 years with a mean of 61.8years.26 patients suffered from gallstones.Abdominal pain (83.3%)and jaundice(40.5%)were the main symptoms.Laboratory examination showed that 13(30.1%)of 29 patients who received CA19-9 examination were positive.Furthermore,23(67.6%)of the 34 patients were suspected or diagnosed by B-type ultrasound,15(48.4%)of 31 patients by computed tomography(CT),19(65.5%)of 29 patients by magnetic resonance cholangiopancreatography(MR-CP)as having gallbladder carcinoma;but 3 patients were misdiagnosed as having cholangiocarcinoma;the median survival rate was respectively different between patients in Nevin stageⅢandⅣ(p＜0.05);39 patients(Nevin stageⅢ,Ⅳ,andⅤ)received radical or extended radical resection and the survival rate of them was better than that of the patients treated with non-radical resection or other palliative procedure.The same analysis was made in Nevin stageⅣandⅤpatients,and the results was alike.Conclusion:patients of gallbladder carcinoma always complicated by gallstones,and suffers the main clinical manifestations abdominal pain and jaundice;clinical workers should be suspicious with the positive CA19-9 examination;B-type ultrasound is easy and cheap should be wildly used;patient in early stage(Nevin stageⅠ,Ⅱ)can get long time survival,while patients in in advanced stage(ⅣandⅤ)always have poor prognosis,but radical or extended radical resection can respectively increase the survival rate of both of them.