[Carcinoma of the gallbladder--current surgical treatment options].
BACKGROUND
The effect of radical resection in gallbladder cancer is still area of debate.


OBJECTIVE
To determine the criteria of surgery in primary and incidental gallbladder cancer. method: Eighty-four patients with gallbladder cancer were evaluated between 1999 and 2008. Sixty patients (72.4%) were symptomatic. Explorative laparotomy was performed in 40 (66.7%), palliative procedure in 5 (8.3%) patients in stage pT3-4, N1, M0-1. Cholecystectomy only or completed with wedge resection of the gallbladder bed and lymfadenectomy as radical procedure was performed only in 7 (1.7%) patients in pT1-2, N0-1, M0. Twenty four (28.6%) patients had incidental gall bladder carcinoma. Radical cholecystectomy was performed in 4 (16.7%) - pT1a, N0, M0, palliative cholecystectomy in 3 patients (12.5%) - pT3, N1, M0. Radical reoperation was performed in 15 (62.5%) patients in stage pT1b-2, N0-1, M0.


RESULTS
Patients survival after explorative laparotomy and palliative procedures was no longer than 7 months. Four from seven patients died after radical operation 12-18 months after operation. Six from 15 radically re-operated patients are alive in interval 4 months and 8 years. Nine patients died in interval 9 months and 4 years after re-operation.


CONCLUSIONS
Radical surgical procedure is the treatment of choice for patients with gall bladder carcinoma especially in stage pT1-2, N0, M0.
Treska
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Chirurgická klinika LF UK a FN v Plzni. treska@fnplzen.cz
Skalický
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Sutnar
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Liska
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D000368:Aged; D000369:Aged, 80 and over; D002763:Cholecystectomy; D005260:Female; D005706:Gallbladder Neoplasms / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012086:Reoperation