Department of Surgery, Canberra Health Services, Canberra, Australia.
School of Medicine and Psychology, Australian National University, Canberra, Australia.
Langenbecks Arch Surg. 2024 Feb 23;409(1):73. doi: 10.1007/s00423-024-03261-8.
The main purpose of this study is to explore the outcomes of patients found to have gallbladder cancer during investigation and diagnosis of acute cholecystitis. The incidence of primary gallbladder cancer co-existing in acute cholecystitis is not well defined in the literature, with anecdotal reports suggesting that they experience worse outcomes than patients with gallbladder cancer found incidentally.
A retrospective review of all patients with gallbladder cancer managed at the Canberra Health Service between 1998 and May 2022 were identified and reviewed.
A total of 65 patients were diagnosed with primary gallbladder cancer during the study period with a mean age of 70.4 years (SD 11.4, range 59-81.8 years) and a female preponderance (74% versus 26%) with a ratio of 2.8. Twenty (31%) patients presented with acute calculus cholecystitis and were found to have a primary gallbladder cancer. This group of patients were older and predominantly female, but the difference was not statistically significant. The overall 5-year survival in the cohort was 20% (stage 1 63%, stage 2 23%, stage 3 16%, and stage 4 0%). There was no statistically significant difference in survival between those who presented with acute cholecystitis vs other presentations.
A third of the patients with gallbladder cancer presented with acute cholecystitis. There was no statistically significant difference in survival in those with bile spillage during cholecystectomy as well those presenting with acute cholecystitis.
本研究旨在探讨在急性胆囊炎的检查和诊断过程中发现胆囊癌患者的结局。原发性胆囊癌合并急性胆囊炎的发病率在文献中尚未明确界定,有传闻报道称,此类患者的预后比偶然发现的胆囊癌患者更差。
回顾性分析了 1998 年至 2022 年 5 月期间在堪培拉卫生服务机构接受治疗的所有胆囊癌患者的病历。
研究期间共诊断出 65 例原发性胆囊癌患者,平均年龄为 70.4 岁(标准差 11.4,范围 59-81.8 岁),女性居多(74%比 26%),比例为 2.8。20 例(31%)患者因急性结石性胆囊炎就诊并发现原发性胆囊癌。这组患者年龄较大且以女性为主,但差异无统计学意义。该队列的总体 5 年生存率为 20%(Ⅰ期 63%,Ⅱ期 23%,Ⅲ期 16%,Ⅳ期 0%)。在急性胆囊炎和其他表现的患者中,生存情况无统计学差异。
三分之一的胆囊癌患者表现为急性胆囊炎。在胆囊切除术中胆汁外溢与急性胆囊炎患者的生存情况无统计学差异。