Department of General Surgery, Gold Coast University Hospital, Gold Coast, Queensland, Australia.
School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia.
ANZ J Surg. 2023 Oct;93(10):2481-2486. doi: 10.1111/ans.18577. Epub 2023 Jun 20.
Gallbladder cancer (GBC) is an uncommon, but highly aggressive cancer. Half of these cases are diagnosed pre-operatively, and the remaining cases are discovered incidentally on post-cholecystectomy specimens. There is a significant geographical variability in GBC incidence, with increasing age, female sex, and prolonged duration of cholelithiasis being risk factors for GBC. The primary aim was to define the overall local incidence of GBC incidental GBC and management of these cases. The secondary aim was to determine any pertinent risk factors in our case population.
A retrospective observational study was performed on all the cholecystectomy specimens at the Gold Coast Hospital and Health Service from 1 January 2016 to 2 December 2021. Data was collected via the electronic medical record. The incidence and management of gallbladder cancers was calculated, and association with body mass index (BMI), smoking status, diabetes, inflammatory bowel disease (IBD) was identified.
3904 cholecystectomy specimens were reviewed. GBC was identified in 0.46% of cholecystectomies. 50% of these cases were found incidentally. Abdominal pain was the most common presenting complaint (94.4%). GBC was associated with increased age and BMI and female sex. There was no association between smoking status, diabetes or IBD with an increased incidence of cancer. Tumour staging guided surgical and/or adjuvant chemotherapy.
GBC is rare. Patients with symptoms are associated with a poor prognosis. Incidental cancers are common, and negative margin resection based on the T stage of the cancer is the most reliable curative option.
胆囊癌（GBC）是一种罕见但高度侵袭性的癌症。其中一半病例在术前诊断，其余病例在胆囊切除术后标本中偶然发现。GBC 的发病率存在显著的地域差异，年龄增长、女性、胆石症持续时间延长是 GBC 的危险因素。主要目的是定义 GBC 偶然发现的总体局部发病率和这些病例的管理。次要目的是确定我们病例人群中的任何相关危险因素。
对 2016 年 1 月 1 日至 2021 年 12 月 2 日期间黄金海岸医院和保健服务中心的所有胆囊切除术标本进行回顾性观察性研究。通过电子病历收集数据。计算了胆囊癌的发病率和管理情况，并确定了与体重指数（BMI）、吸烟状况、糖尿病、炎症性肠病（IBD）的关联。
共回顾了 3904 例胆囊切除术标本。在 0.46%的胆囊切除术中发现了 GBC。这些病例中有 50%是偶然发现的。腹痛是最常见的首发症状（94.4%）。GBC 与年龄增长、BMI 和女性性别有关。吸烟状况、糖尿病或 IBD 与癌症发病率增加之间没有关联。肿瘤分期指导手术和/或辅助化疗。
GBC 罕见。有症状的患者预后较差。偶然发现的癌症很常见，根据癌症的 T 分期进行无肿瘤边缘切除是最可靠的治愈选择。
