Literature DB >> 24279377

Management of incidental and suspicious gallbladder cancer: focus on early referral to a tertiary centre.

Vincent S Yip1, Dhanwant Gomez, Sean Brown, Clare Byrne, David White, Stephen W Fenwick, Graeme J Poston, Hassan Z Malik.   

Abstract

OBJECTIVES: This study was conducted to assess the management of incidental gallbladder cancer and indeterminate gallbladder lesions. Its secondary aim referred to the devising of a management pathway for these patients.
METHODS: Patients referred with incidental gallbladder cancer and indeterminate gallbladder lesions during 2002-2011 were identified from a prospectively maintained database. Collated data included operative findings, histopathological data and survival outcomes.
RESULTS: The study included a total of 104 patients, 40 of whom had incidental gallbladder cancer following cholecystectomy. In this group, the index cholecystectomy was considered curative (T-is/T1a stage) in three patients; 11 patients underwent further resection, and 26 patients were inoperable. One-, 3- and 5-year overall survival rates were 91.1%, 91.0% and 60.7%, respectively, in patients who underwent re-resection. Of the 64 patients with indeterminate gallbladder lesions, 54 patients underwent modified radical cholecystectomy. Seven patients were found to have gallbladder cancer. One-, 3- and 5-year overall survival rates were 85.9%, 43.1% and 42.8%, respectively. Five-year overall survival in patients treated with surgery for gallbladder cancer was 59.9%.
CONCLUSIONS: The majority of patients with incidental gallbladder cancer were not amenable to further potentially curative resection. The radiological suspicion of gallbladder cancer should lead to prompt referral to a tertiary hepatobiliary unit for further management.
© 2013 International Hepato-Pancreato-Biliary Association.

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Year:  2013        PMID: 24279377      PMCID: PMC4105902          DOI: 10.1111/hpb.12189

Source DB:  PubMed          Journal:  HPB (Oxford)        ISSN: 1365-182X            Impact factor:   3.647


  33 in total

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