title: Gallbladder neoplasm: a single institution experience according to the standard current management.
abstract: OBJECTIVE
  The aim of this paper was to determine if an aggressive surgical approach, with an increase in R0 resections, has resulted in improved survival for patients with gallbladder cancer. Gallbladder cancer is a silent disease, despite the efforts, the prognosis remains dismal. Consensus among surgeons regarding the indications for the extent of resection, lymph node dissection, port site resection, bile duct management has not been reached.
  
  
  METHODS
  A retrospective review of all patients with gallbladder cancer admitted during 12 years period was conducted. Sixteen patients were identified. Cases were divided into 2 cohorts surgical treated group (STG, N.=10) and non surgical treated group (NSTG, N.=6).
  
  
  RESULTS
  In NSTG the disease was metastatic (stage IV): liver (33.3%), peritoneum (50%), liver and peritoneum (16.7%). In STG 13 procedures were performed, 6 liver resection (2 en bloc resection, 2 bisegmentectomy, 2 wedge resection) 7 cholecystectomies. 6 R1, 7 R0 resections. All the liver resections were R0. 0% mortality, 30.7% of morbidity, all the complications were managed conservatively. Length of stay was 10 days for the STG, and 5 days for the NSTG. The median overall survival was 10 months (Std Error 2.381 CI 5.333-14.667), while in the STG 16 months (Std Error 6.275 CI 3.701-28.299) and in the NSTG was 7 months (Std Error 2.381 CI 5.337-14.667)
  
  
  CONCLUSIONS
  Whenever is possible radical resection with free margin (R0) must be achieved, being the only chance to treat efficiently.
authors.affiliation: Surgical and Anesthesiologist Science Course, Careggi Academic and Regional Hospital, Florence, Italy. m.rossi@unifi.it
authors.forename: M
authors.initials: M
authors.lastname: Rossi
authors.forename: L
authors.initials: L
authors.lastname: Bencini
authors.forename: M
authors.initials: M
authors.lastname: Calistri
authors.forename: R
authors.initials: R
authors.lastname: Manetti
authors.forename: M
authors.initials: M
authors.lastname: Farsi
mesh_terms: D000368:Aged; D002763:Cholecystectomy / Q000592:standards*; D005260:Female; D005706:Gallbladder Neoplasms / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies