title: Biliary obstruction in gall bladder cancer is not sine qua non of inoperability.
abstract: BACKGROUND
  The presence of biliary obstruction in patients with gallbladder cancer (GBC) is generally viewed as an indicator of advanced disease, inoperability and poor prognosis.
  
  
  METHODS
  Data was collected from patients with GBC with obstructive jaundice who underwent resection during the period January 2001 to October 2003. Systematic analysis of prospective data was undertaken; patients were analyzed for resectability, post-operative morbidity, mortality and disease-free survival.
  
  
  RESULTS
  During this period 14 patients with GBC with biliary obstruction underwent resection with curative intent. In these jaundiced patients, the resectability rate was 27.45% (14 of 51). In the jaundiced group the mortality was 7.14% the morbidity rate 50%, the mean disease free survival was 23.46 months (median 26 months and range of 2 to 62 months). Seven patients (50%) survived more than two years.
  
  
  CONCLUSIONS
  Biliary obstruction in gall bladder cancer is not sine qua non of inoperability and resection results in meaningful prolongation of survival.
authors.affiliation: Department of Gastrointestinal Surgery, GB Pant Hospital & Maulana Azad Medical College, JLN Marg, New Delhi 110002, India. aka.gis@gmail.com
authors.forename: Anil K
authors.initials: AK
authors.lastname: Agarwal
authors.forename: Sanjoy
authors.initials: S
authors.lastname: Mandal
authors.forename: Shivendra
authors.initials: S
authors.lastname: Singh
authors.forename: Rajesh
authors.initials: R
authors.lastname: Bhojwani
authors.forename: Puja
authors.initials: P
authors.lastname: Sakhuja
authors.forename: Rajeev
authors.initials: R
authors.lastname: Uppal
mesh_terms: D000328:Adult; D000368:Aged; D000713:Anastomosis, Roux-en-Y; D017734:Bile Ducts, Extrahepatic / Q000473:pathology / Q000601:surgery; D003952:Diagnostic Imaging; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D005706:Gallbladder Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D006498:Hepatectomy; D006801:Humans; D041781:Jaundice, Obstructive / Q000175:diagnosis / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D007582:Jejunostomy; D010535:Laparoscopy; D008099:Liver / Q000473:pathology; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010166:Palliative Care; D011183:Postoperative Complications / Q000401:mortality; D011446:Prospective Studies