Gyan Burman Hepatobiliary Unit, Department of Surgical Gastroenterology and Liver Transplantation, Sir Ganga Ram Hospital, New Delhi 110060, India.
Dig Surg. 2009;26(4):306-11. doi: 10.1159/000231880. Epub 2009 Aug 5.
The presence of jaundice or an abdominal lump in gall bladder cancer (GBC) is often translated to advanced and unresectable disease. We examined whether this was true.
We retrospectively analysed 120 GBC patients, who had been operated on, for presenting symptoms, staging and resectability. The outcomes in patients with jaundice and/or an abdominal lump were compared with those who did not have these features. Early disease was represented by stages I and II, while stages III and IV represented advanced disease.
Sixty-eight patients (57%) presented with an abdominal lump and 62 (52%) had jaundice. An abdominal lump, jaundice or both were present in 89 patients (74%), of whom 78 (88%) had advanced disease, while 22 of the 31 patients (71%) with neither jaundice nor an abdominal lump had advanced disease. Forty-four patients (50%) with either or both of these features had R0 resections, while 20 patients (64%) with neither jaundice nor an abdominal lump had R0 resections. The presence of jaundice or an abdominal lump was significantly associated with advanced disease (p = 0.025), but not with unresectability (p = 1).
Jaundice or an abdominal lump was present in 74% of the patients with GBC. While this represented advanced-stage cancer, it did not preclude resectability.
在胆囊癌（GBC）中，出现黄疸或腹部肿块通常被认为是晚期且不可切除的疾病。我们研究了这种说法是否正确。
我们回顾性分析了 120 例接受手术治疗的 GBC 患者的临床表现、分期和可切除性。比较了有黄疸和/或腹部肿块的患者与无这些特征的患者的结局。早期疾病代表 I 期和 II 期，而 III 期和 IV 期代表晚期疾病。
68 例（57%）患者出现腹部肿块，62 例（52%）患者出现黄疸。有腹部肿块、黄疸或两者均有的患者为 89 例（74%），其中 78 例（88%）为晚期疾病，而 31 例既无黄疸也无腹部肿块的患者中，仅有 22 例（71%）为晚期疾病。44 例（50%）有或两者均有的患者行 R0 切除术，而 20 例（64%）既无黄疸也无腹部肿块的患者行 R0 切除术。黄疸或腹部肿块的存在与晚期疾病显著相关（p = 0.025），但与不可切除性无关（p = 1）。
在 GBC 患者中，有 74%的患者出现黄疸或腹部肿块。虽然这代表了晚期癌症，但并不排除可切除性。
