Carcinoma of Gallbladder: Its Frequency and Clinical Presentations in two hundred cases of Cholelithiasis

Tahir Uddin Qazi, Fazal Ahmad, Mohammad Tahir, Nafisa Batool Tahir

Abstract


Background: Primary carcinoma of the gallbladder is the most common biliary tract tumor. Although its exact aetiology is not known, gallstones are considered to be an important risk factor for the development of carcinoma of the gallbladder. The objectives of the study were to find out frequency of carcinoma gallbladder in patients suffering from cholelithiasis and the frequency of symptoms, signs, ultrasonographic findings, per-operative and histopathologic findings in patients having carcinoma gallbladder. Material and Methods: This cross sectional study was carried out in the Surgical Unit of Kohat Development Authority Hospital, Kohat from January 2009 to June 2011. All patients having gallstones were included in this study. Patients unfit for general anesthesia or positive for HBV, HCV or HIV were excluded from the study. Results: Out of the 200 patients cholecystectomy was possible in 193 patients. The frequency of carcinoma of gallbladder in our study was 4% with female to male ratio of 7:1. The main presenting complaints were pain in the right upper quadrant of abdomen, anorexia, nausea, vomiting, weight loss and jaundice. The main clinical signs were mass in the right hypochondrium (50%) and jaundice (37.5%). 87.5% patients were in stage IV disease. 7 patients had inoperable malignant disease at the time of surgery. Conclusions: This study concluded that the frequency of carcinoma of the gallbladder is the same as elsewhere in the world but the gallstones disease and carcinoma gallbladder affects comparatively younger female patients of low socioeconomic status.

Keywords


Biliary tract neoplasms; Gallbladder; Cholelithiasis; Gallbladder neoplasms

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References


Levy AD, Murakata LA, Rohrmann CA. Gallbladder Carcinoma: Radiologic-Pathologic correlation. Radiographics 2001;21:295-314.

Jemal A, Siegel R, Ward E, Murray T, Xu J, Thun MJ. Cancer Statistics 2007. Cancer Occurrence, Department of Epidemiology and Surveillance Research, American Cancer Society, Atlanta, GA, USA. CA-Cancer J Clin 2007; 57: 43-66.

Kratzer W, Mason RA, Kachele V. Prevalence of gallstones in sonographic surveys worldwide. J Clin Ultrasound 1999; 27: 1-7.

Misra N.C, Misra S, Chaturvedi A. Carcinoma of the gallbladder. In: Taylor I, Johnson CD (Eds). Recent advances in Surgery. New York: Churchill Livingstone; 1997: 69-88.

Lowenfels AB, Maisonneuve P, Boyle P, Zatonski WA. Epidemiology of gallbladder cancer. Hepatogastroenterology 1999; 46:1529-32.

Pandey M, Shukla VK. Lifestyle, parity, menstrual and reproductive factors and risk of gallbladder cancer. Eur J Cancer Prev 2003;12:269-72.

So CB, Gibney RG, Scudamora CH. Carcinoma of the gallbladder: a risk associated with gallbladder preserving treatments for cholelithiasis. Radiology 1990; 174: 127-30.

Dowling GP, Kelly J K. The histiogenesis of adenocarcinoma of the gallbladder: Cancer 1986; 58: 1702- 8.

Cubertafond P, Gainant A, Cucchiaro G. Surgical treatment of 724 carcinomas of gallbladder: results of French Surgical Association survey. Ann Surg 1994; 219: 275-80.

Kapoor VK, Pradeep R, Haribhakti SP. Early carcinoma of the gallbladder: an elusive disease. J Surg Oncol 1996; 62:284-7.

Strom BL, Soloway RD, Dalenz JL. Risk factors for gallbladder cancer. An international collaborative case control study. Cancer 1995;76: 1747-56.

Aretxabala X de, Rao I, Burgos L. Gallbladder cancer in Chile. A report on 54 potentially resectable tumours. Cancer 1992;69: 60-5.

Ahmed I. Prevalence of carcinoma of the gallbladder in patients with cholelithiasis. Pak J Med Sci 1995; 3: 213-7.

Uddin A. Some observations on gallbladder disease in West Pakistan. Pak J Med Res 1964: 106-12.

Haroonwala ZG. . Carcinoma of Gallbladder. Pak J Surg 1990; 6: 96-8.

Mubarik A, Ahmed M, Khan AH, Mansoor A. Carcinoma of gallbladder. A study of 112 consecutive cases. Pak AF Med J 1990; 24: 1-7.

Yaqin HU, Parmer BK. A comparative study of biliary tract disease in Karachi and Aylesbury. J Pak Med Assoc 1976; 26: 162-4.

Sheikh SM, Sheikh IA, Mughal SA. Incidence of gallbladder malignancy in patients with cholelithiasis .J Surg Pak 1999; 4: 27-38.

Sultan N, Talat M, Ashraf S, Rehman SU, Uddin N, Hussan A, et al. Gallbladder cancer in Pakistan. Pak J of Gastroenterol 1994; 3:38-44.

Cubertafond P, Mathonnet M, Gainant A, Launois B. Radical surgery for gallbladder cancer. Hapatgastroenterology 1999: 46: 1567-71.

Shrauch GO. Primary carcinoma of the gallbladder; Ann Surg 1960;47: 368-75.

Parakevopoulos JA, Dennison AR, Ross B, Johnson AG. Primary carcinoma of the gallbladder: a 10-year experience. Ann R Coll Surg Engl 1992; 74: 422-4.

Wanebo HJ, Castle WN, Fechner RE. Is carcinoma of the gallbladder a curable lesion? Annals of Surgery 1982. 195: 624 – 31.

Collier NA, Cau D, Hemingway A, Blumgart LH. Preoperative diagnosis and its effects on the treatment of carcinoma of the gallbladder. Surg Gyn Obst 1984;159:465-70.

Chijiiwa K, Yamaguchi K, Chimiya H, Sada M, Kawakami K, Nishikata F. Gallbladder carcinoma in the era of Laproscopic Cholecystectomy. Arch. Surg. 1996; 131: 981-4.

Chaudhry Z U, Ayaz M. The incidence of gallbladder cancer and its aetiological factors in developing countries. Neth Jr Hepatobiliary Surgery 1989; 27: 134-7.


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