Publication:

Clinicopathological study of gall bladder carcinoma with special reference to its management in a tertiary care hospital

Background Incidence of gallbladder carcinoma is increasing progressively among Indians and is regarded as a major cause of mortality and morbidity. In spite of this, limited studies have been conducted so far. Objective of the study was to know the prevalence, clinicopathological aspects, and prevalent treatment protocol of gall bladder cancer in a tertiary care hospital in Eastern India.

Methods 64 cases of histologically proven gallbladder cancer patients were studied. Patient characteristics were recorded using pretested proforma along with relevant investigations, and histopathology and treatment provided were recorded.

Results Our study reveals that gallbladder cancer has a prominent peak in the 7th decade of life with male: female ratio of 1:2.2. Most of the patients were having body mass index between 20.0 and 24.99, which is in sharp contrast to the available literatures. Pain is the most common symptom followed by constitutional symptoms. Majority of cases presented at advanced stage (64.1%) with significantly elevated CA19.9 level, and were managed with palliative chemotherapy.35.9% of our cases were respectable at the time of diagnosis, and extended cholecystectomy could be performed in 31.3%. Log rank test showed pattern of survival of the patients who were resected was significantly better than those of who were not resected.

Conclusions We know gallbladder cancer is a disease with very few patients amenable to surgery at the time of presentation. Thus, instead of retrospectively analyzing individual institutional data, high volume institutions with the necessary expertise for treating gallbladder cancer should collaborate with a view of generating strong evidence-based surgical guidelines.