Experience in the diagnosis and treatment of primary gallbladder cancer

Objective To summerize our experience for the diagnosis and surgical management for primary gallbladder cancer.MethodsIn this study the clinical data of 134 patients suffering from primary gallbladder carcinoma proved by both laparotomy and pathology in our hospital were retrospectively analyzed.Results Patients were 50 men 〔mean age (56±14) years〕 and 84 women 〔mean age (59±16) years〕,followed up for 6 months～16 years.The diagnostic accuracy of B ultrasound was 54 3%(88/162);of color Dopple ultrasound 69% (29/42);of contrast enhanced CT 85% (46/58).Simple cholecystectomy was performed in 6 patients of Nevin's stage Ⅰ,among them 4 cases have survived more than 5 years; 66 cases with Nevin's stage Ⅱ～Ⅳ carcinoma received radical cholecystectomy, the mean survival was 20 months; 17 patients of Nevin's stage Ⅴ received radical or extended radical cholecystectomy,the postoperative mean survival was 15 months whereas 10 patients with Nevin's stage Ⅴ undergoing palliative cholecystectomy had only a mean survival of 6 months; 35 patients with Nevin's stage Ⅴ undergoing a mere laparotomy survived an average of 2 months.Conclusions The colour Dopple ultrasound is the first line diagnostic means for early gallbladder cancer. Xanthogranulomatous cholecystitis should be carefully differentiated from locally advanced gallbladder cancer when a non surgical management was to be employed. Patients diagnosed with Nevin's stage Ⅴ gallbladder carcinoma should undergo laparotomy in an attempt to perform resection provided that the constitutional condition of the patients allows this procedure.