Radical operations for carcinoma of the gallbladder: Present status in Germany

Gall, F. P.; Köckerling, F.; Scheele, J.; Schneider, Claus; Hohenberger, Werner

doi:10.1007/bf01658724

Cited by 99 publications

(67 citation statements)

References 13 publications

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“…Since there is no serosal layer at the gallbladder fossa and the thicker cystic plate is invariably left behind after simple cholecystectomy, IVB and V segment resection is mandatory [36]. The reported incidence of lymph node metastasis in pT2, T3 and T4 stages were 39-54 %, 62 % and 69 % respectively [37,38].…”

Section: Algorithmic Approach For Igbc Discovered During Cholecystectomymentioning

confidence: 99%

Incidentally Detected Gallbladder Cancer- The Controversies and Algorithmic Approach to Management

et al. 2012

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Incidentally discovered gallbladder cancer (IGBC) is defined as the gallbladder cancer (GBC) diagnosed during or after the cholecystectomy done for unsuspected benign gallbladder disease. Laparoscopic cholecystectomy (LC) is the most common procedure performed for benign gallbladder disease worldwide. Majority of GBC patients have associated gallstones. With the advent of ultrasonography more patients are being diagnosed with gallstones and are being subjected to cholecytectomy. IGBC is found in 0.2-2.9 % of all cholecytectomies done for gallstone disease. It represents 27-41 % of all GBC. Patients with IGBC having Tis and T1a stage, with negative cystic duct margin can be treated by simple cholecystectomy alone. Patients with stage T1b and beyond should undergo restaging, and should be treated with radical re -resection (R0). Residual disease is found in 40-76 % patients on re-exploration. The survival rates of patients undergoing re resection for IGBC is similar to those undergoing primary radical surgery. LC is contraindicated in patients with GBC. Patients presenting post LC should undergo radical re-resection and additional port site excision, as they have a high incidence of port site metastasis. At cholecystectomy for benign gallbladder disease all gallbladder specimens should be opened before closing abdomen and if available all suspicious specimens should be sent for immediate frozen section. All gallbladder specimens should be subjected to histopathology examination to avoid missing GBC. The surgeon should have a high index of suspicion for GBC if encountering difficult cholecystectomy for a benign disease, and in patients with atypical clinical and ultrasound findings in high incidence areas.

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Section: Algorithmic Approach For Igbc Discovered During Cholecystectomymentioning

confidence: 99%

Incidentally Detected Gallbladder Cancer- The Controversies and Algorithmic Approach to Management

et al. 2012

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“…The 5-year survival rate after surgery is less than 15% (Donohue et al, 1990;Gall et al, 1991;Oertli et al, 1993;Cubertafond et al, 1994;Ruckert et al, 1996). The prognostic factors for gallbladder cancer are lymph-node metastases and the local extent of the primary tumour, which significantly influence surgical course and determine the prognosis after surgery (Tsukada et al, 1997;Sugawara et al, 1999).…”

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confidence: 99%

Clinical significance of immune cell infiltration within gallbladder cancer

et al. 2003

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To investigate the pathophysiological significance of infiltrating antitumour immune cells, we evaluated the quantity of immune cell intratumoral infiltration in 110 surgically resected gallbladder specimens by immunohistochemistry. We examined 45 cases of gallbladder cancer and 65 cases of benign gallbladder diseases for CD4 þ T cells, CD8 þ T cells, natural killer cells (NKCs), and dendritic cells (DCs). High levels of CD4 þ T cell, CD8 þ T cell, NKC, and DC infiltration were recognised in 51.1% (23 out of 45), 37.8% (17 out of 45), 33.3% (15 out of 45), and 48.9% (22 out of 45) of cancer specimens, respectively. High numbers of infiltrating CD4 þ and CD8 þ T cells correlated with decreasing tumour invasion, and high numbers of infiltrating DCs correlated with decreasing lymph-node tumour metastasis. Furthermore, increased infiltration of CD4 þ and CD8 þ T cells and DCs exhibited a significant correlation with prolonged survival. NKC infiltration, however, did not correlate with any of the clinicopathological factors examined. Additionally, high levels of infiltration were not identified in specimens from benign diseases, consistent with the cancerspecific activity of CD4 þ and CD8 þ T cells and DCs. In this study, we demonstrate that CD4 þ and CD8 þ tumour-infiltrating lymphocyte and DCs, but not NKCs, are important factors in the accurate prognosis of survival after surgical removal of gallbladder adenocarcinoma.

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“…Estos casos representan la mayoría de los pacientes de la serie. (19) La ventaja de realizar una segunda intervención más radical después de una colecistectomía en el caso de un hallazgo accidental de carcinoma de la vesícula, depende de la fase de la enfermedad.…”

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Gallbladder Carcinoma. A 10 Years' Experience at National Cancer Institute

et al. 2016

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RESUMENAntecedentes: El cáncer de la vesícula biliar tiene baja frecuencia en Sudamérica, excepto en Chile; por lo general es diagnosticado y tratado en etapas avanzadas. Objetivo: Estudiar la frecuencia, sexo, edad, factores de riesgo, el cuadro clínico, el diagnóstico, los resultados de la cirugía en pacientes con cáncer vesicular y el pronóstico al momento del diagnostico. Material y método: estudio descriptivo y retrospectivo basado en pacientes tratados en el Instituto Nacional del Cáncer en el periodo 2005-2015. Fueron seleccionados los casos comprobados de cáncer vesicular; se evalúan: frecuencia, edad, sexo, factor de riesgo, cuadro clínico, estadio al diagnóstico, anatomía patológica, tratamiento y pronóstico. Resumen: 36 casos de cáncer vesicular, 3,6 casos nuevos por año, 75% fueron mujeres. La edad media fue 59,5 años. Los factores de riesgo fueron litiasis vesicular en 87%, obesidad 8%, pólipo vesícula 2% y sin factor de riesgo 3%. Ninguno de los pacientes presento antecedentes patológicos familiares. El 100% los pacientes fueron inicialmente intervenidos en otros servicios quirúrgicos del país y luego fueron remitidos a nuestra institución para mejor tratamiento en dichos servicios. Se realizó colecistectomía simple en 26 casos, colecistectomía parcial en 2 casos, colecistectomía + drenaje externo en 3 de los casos, colecistectomía + biopsia ganglionar en 3 casos, y solo biopsia en 2 casos por enfermedad diseminada. El 14% de los pacientes presentó ictericia + coluria + acolia. La estatificación al ingreso fue un estadio IV b en un 83%, IV a 11 % y III b 6 %. A los resultados de anatomía patológica se pudo constatar que el adenocarcinoma predomino en 82% ante el carcinoma escamoso 12% y mal diferenciado 6%.El tratamiento propuesto por el equipo multidisciplinario ya en nuestra institución fue en 7 casos cirugía, quimioterapia exclusiva en 1 caso, quimioterapia paliativa en 5 pacientes, cuidados paliativos exclusivos en 18 casos. Vale la pena mencionar que 5 pacientes se negaron a tratamiento alguno solicitando el alta voluntaria. ABSTRACTCabe destacar que un paciente de la serie el cual recibió tratamiento quirúrgico (linfadenectomia radical+ resección hepática IV Y V) más quimioterapia y radioterapia adyuvante tuvo una sobrevida de 4 años, el resto de los pacientes ingresaron con mal pronóstico y la sobrevida promedio no fue más de 6 meses. Palabra clave: mujer, vesícula biliar, cáncer de la vesícula biliar, colecistectomía.There were found 36 cases of gallbladder cancer, an average of 3.6 new cases per year, 75% were women. The mean age was 59.5 years (40-80 r). As a major risk factor for gallstone disease found in 87%, 8% obesity, gallbladder polyp 2% without risk factor none 3% of patients presented family medical history associated with this pathology. The 100% patients were initially operated in other surgical services in the country and then were referred to our institution for better treatment in these services simple cholecystectomy was performed in 26 cases partial. Cholecystectomy in 2 c...

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Radical operations for carcinoma of the gallbladder: Present status in Germany

Cited by 99 publications

References 13 publications

Incidentally Detected Gallbladder Cancer- The Controversies and Algorithmic Approach to Management

Incidentally Detected Gallbladder Cancer- The Controversies and Algorithmic Approach to Management

Clinical significance of immune cell infiltration within gallbladder cancer

Gallbladder Carcinoma. A 10 Years' Experience at National Cancer Institute

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