Department of Biliary Surgery, Eastern Hepatobiliary Surgical Hospital, Second Military Medical University, Shanghai 200438, China.
Chin Med J (Engl). 2012 Mar;125(5):752-6.
Gallbladder carcinoma (GBC) is a commonly-seen malignancy of the biliary tract characterized by difficult early diagnosis, rapid growth, early metastasis, and poor prognosis. Nearly half of GBC patients also have jaundice, which is a mark of the advanced stage of GBC. The role of radical resection in patients of gallbladder carcinoma with jaundice is still a matter of uncertainty, which we attempted to clarify in this study.
Totally, 251 GBC patients who received treatment at the Eastern Hepatobiliary Surgery Hospital (EHBH) from December 2002 to January 2010 were recruited into this study. We divided them into group A (jaundice group, n=117) and group B (non-jaundice group, n=134). Clinical records and follow-up data were collected and retrospectively analyzed in both groups.
Compared with group A, patients in group B had a longer median survival time ((6.0±0.5) months vs. (15.0±2.6) months, P<0.01). Even in patients with stage III or stage IV GBC, the median survival time in patients without jaundice (n=111), was still longer than that in patients with jaundice (n=116) (P<0.01). The radical resection rate was lower in group A patients than in group B patients with stage III or stage IV GBC; 31.9% vs. 63.1%. However, the median survival time of patients undergoing radical resection did not show a statistical difference between jaundice patients and non-jaundice patients; (12.0±4.3) months vs. (18.0±3.0) months (P>0.05).
GBC with jaundice usually implies advanced stage disease and a poor prognosis for the patients. However, our findings indicate that as long as the patient's condition allows, radical resection is still feasible for GBC patients with jaundice, and may achieve a prognosis close to those GBC patients without jaundice.
胆囊癌（GBC）是一种常见的胆道恶性肿瘤，其特点是早期诊断困难、生长迅速、早期转移和预后不良。近一半的 GBC 患者也有黄疸，这是 GBC 晚期的标志。根治性切除术在黄疸型胆囊癌患者中的作用仍存在不确定性，我们试图在本研究中阐明这一问题。
本研究共纳入 2002 年 12 月至 2010 年 1 月在东方肝胆外科医院（EHBH）接受治疗的 251 例 GBC 患者。我们将他们分为 A 组（黄疸组，n=117）和 B 组（非黄疸组，n=134）。收集并回顾性分析了两组患者的临床记录和随访资料。
与 A 组相比，B 组患者的中位生存时间更长（（6.0±0.5）个月比（15.0±2.6）个月，P<0.01）。即使在 III 期或 IV 期 GBC 患者中，无黄疸患者（n=111）的中位生存时间仍长于黄疸患者（n=116）（P<0.01）。III 期或 IV 期 GBC 患者中，A 组患者的根治性切除率低于 B 组；31.9%比 63.1%。然而，黄疸患者和非黄疸患者行根治性切除术的中位生存时间无统计学差异；（12.0±4.3）个月比（18.0±3.0）个月（P>0.05）。
黄疸型 GBC 通常提示疾病处于晚期，患者预后较差。然而，我们的研究结果表明，只要患者情况允许，根治性切除术仍是可行的，黄疸型 GBC 患者可获得接近无黄疸患者的预后。
