Abstract

JARAMILLO, Paula María  and  HOYOS, Sergio Iván. Carcinoma of the gallbladder at Pablo Tobón Uribe Hospital (Medellín, Colombia). rev. colomb. cir. [online]. 2009, vol.24, n.4, pp.250-257. ISSN 2011-7582.

Objectives. To analyze the experience with patients with carcinoma of the gallbladder at the Hepatobiliary and Pancreatic Unit of Pablo Tobón Uribe Hospital (Medellín, Colombia), registering the clinical course and outcomes. Patients and methods. All patients with the diagnosis of carcinoma of the gallbladder admitted to the Hepatobiliary and Pancreatic Unit during the period January 1, 2004, to June 30, 2008 were analyzed. The diagnostic methods were studied, together with the stage of the disease, the type of surgery performed, and the results measured in terms of hospital stay and related mortality. Results. Forty patients were collected, 55% women and 45% men, with average age of 60.4 years. Preoperative diagnosis was established preoperatively in 62.5% of the patients, and as incidental finding at cholecystectomy in 37.5%. CT scan was the most common diagnostic method utilized, both for diagnosis (28%) and for staging (53.3%). Tumor stage at operation was: stage IV in 72.5% of cases, followed by stage IB in 12.5%. In only 22.5% of all patients resection with curative intention was possible, and of these patients, 77.8% had had the diagnosis established after the initial cholecystectomy. Central hepatectomy (segments IVB/V) with first level lymph node dissection was the most common procedure. These patients had an average hospital stay of 7.8 days, with ICU stay of 0.7 days. No mortality related to the procedure occurred. Average postoperative general survival was 6.7 months, with an average one year survival rate of 27.5%. Conclusion. Carcinoma of the gallbladder continues to exhibit an ominous prognosis in spite of the advent of improved diagnostic methods and radical surgical procedures, due mainly to the fact that the majority of cases present with an advanced stage of the disease. However this is still the only treatment modality potentially curable.

Keywords : gallbladder neoplasms; diagnosis; clinical evolution; prevalence; mortality.

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