Sampetoding Samuel, Kusuma Muhammad Ihwan, Pratiwi Yulianti, Ulfandi Devby, Faruk Muhammad
Division of Digestive Surgery, Department of Surgery, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia.
Department of Surgery, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia.
Int J Surg Case Rep. 2022 Nov;100:107734. doi: 10.1016/j.ijscr.2022.107734. Epub 2022 Oct 11.
The most prevalent malignancy of the biliary system and the fifth most common cancer of the gastrointestinal tract is gallbladder cancer. This cancer is extremely aggressive with a 19 % 5-year survival rate. Herein, we report a case of gallbladder cancer with an ambiguous symptom of upper abdominal pain.
A 51-year-old woman presented with abdominal pain persisting for 3 months. On examination, a lump on the right abdomen measuring 7 × 5 cm was found. Ultrasound showed a gallbladder mass measuring 8 cm, and magnetic resonance imaging showed an infiltrating gallbladder mass suggestive of segment VI liver malignancy. The patient underwent radical cholecystectomy with en bloc hepatectomy and lymph node dissection. Histopathology revealed poorly differentiated gallbladder adenocarcinoma that metastasized to the liver. The postoperative course was uneventful, and the patient was discharged on postoperative day 5.
In our case, we performed radical (extended or margin-clearing) cholecystectomy to remove the gallbladder with a margin of normal liver tissue along with regional lymphadenectomy. This procedure is used to improve staging and decrease the risk of recurrence.
Although gallbladder cancer is rare in Indonesian populations, it has a high mortality rate because of the frequently advanced stage of the disease at the time of diagnosis. Radiography may determine its degree and malignancy features. Regardless of the tumor size, the prognosis of gallbladder cancer depends on its stage and removability.
胆囊癌是胆道系统最常见的恶性肿瘤，也是胃肠道第五大常见癌症。这种癌症极具侵袭性，5年生存率为19%。在此，我们报告一例有上腹部疼痛模糊症状的胆囊癌病例。
一名51岁女性出现持续3个月的腹痛。检查时，在右腹部发现一个7×5厘米的肿块。超声显示胆囊肿块大小为8厘米，磁共振成像显示胆囊肿块浸润，提示肝VI段恶性肿瘤。患者接受了根治性胆囊切除术，包括整块肝切除术和淋巴结清扫术。组织病理学显示低分化胆囊腺癌已转移至肝脏。术后过程顺利，患者于术后第5天出院。
在我们的病例中，我们进行了根治性（扩大或切缘清除）胆囊切除术，以切除带有正常肝组织切缘的胆囊，并进行区域淋巴结清扫术。该手术用于改善分期并降低复发风险。
尽管胆囊癌在印度尼西亚人群中很少见，但由于在诊断时疾病常常处于晚期，其死亡率很高。影像学检查可以确定其程度和恶性特征。无论肿瘤大小如何，胆囊癌的预后取决于其分期和可切除性。
