A prospective study of radical cholecystectomy for gallbladder carcinoma

Abstract

Background: Gallbladder cancer tends to be an aggressive tumor that spreads early and leads to rapid death. The clinical pessimism surrounding gallbladder cancer is because of its late presentation and lack of effective therapy. Definitive resection for Gallbladder cancer depends on stage and location of the tumour as well as whether it is repeat resection after a previous simple cholecystectomy. Serious problems soon after surgery can include bile leakage into the abdomen, infections, and liver failure. Material and Methods: From the report of Hospital Based Cancer registry (HBCR) of CNCI information regarding all cancer cases were collected and analyzed to find the proportion of cancer in gall bladder cases. Patients for this study was selected from the patients who undergone radical cholecystectomy for gall bladder carcinoma. Morbidity and mortality of the patient were observed within 30 days of procedure. Results: Proportion gall bladder cancer cases for male and female was 3.7% and 8.94% respectively and overall proportion observed was 6.28%. The incidence of wound infection was higher in diabetics than non diabetics in patients undergoing CRS (15.4 vs. 11.0%, P < 0.001) and patients undergoing GS (5.3 vs. 3.1%, P < 0.001). Bile leakage is common with patients undergone common bile duct resection. Among 6 patients underwent CBD resection, 4 patients had <50ml bile leakage post operatively. Out of 30 patients, one hypertensive patient developed acute myocardial infacrtion.10 % patient had suffered major bleeding and given 3units of blood. The mean number of post-operative blood transfusion of the patients was 1.83±0.59 units with range 1-3 units. Conclusion: Proportion gall bladder cancer observed was 6.28%. As radical cholecystectomy is a major procedure, we encountered few post operative complications like bleeding, septicemia wound infection, bile leak etc.