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- Title
Management of gallbladder cancer.
- Authors
Castillo, Felipe; de Aretxabala, Xabier; Torres-Quevedo, Rodrigo; Lim, Fiona; Wan, Bo Angela; Silva, Mauricio F.
- Abstract
Gallbladder cancer (GC) is considered a rare disease mainly affecting some countries in South America, Eastern Europe and places in India. Prognosis of the disease is commonly dismal, except in cases when diagnosis is performed after the exam of the cholecystectomy specimen of patients undergoing surgery for cholelithiasis. Gallstones disease is the most commonly associated factor, which in countries such as Chile, is observed in approximately 95% of GC patients. Among prognostic factors, the level of wall invasion and lymph nodes metastasis are the most important. Present GC classification is mainly based on these factors. Surgical resection is the only curative therapy, while chemotherapy and radiation have not shown significant benefit in either neoadjuvant or adjuvant setting. Cholecystectomy is a valid option of treatment in patents with invasion limited to the mucosa or muscular layers, while more extended operations including resection of the gallbladder bed and regional lymph nodes are advised in patients with invasion of the subserosal layer and deeper. A R0 resection is the only option to affect the survival in patients undergoing surgery, palliative surgery would not have a role. Jaundice pain and outlet obstruction are the main symptoms to palliate, and endoscopy has shown to be the most cost-effective way for management.
- Subjects
LATIN America; CHOLECYSTECTOMY; ENDOSCOPY; GALLBLADDER tumors; JAUNDICE; PAIN; POPULATION geography; GASTRIC outlet obstruction; SYMPTOMS
- Publication
Journal of Pain Management, 2019, Vol 12, Issue 3, p275
- ISSN
1939-5914
- Publication type
Article