Analysis of the Cases with Carcinoma Gallbladder (CA GB) in a Tertiary Level Hospital of Nepal

Abstract

Introduction: Gallbladder cancer (GC) is a rare disease in some parts of world but is common in countries like Chile, Japan, India and Nepal. Nepal stands as one of the five countries with the highest mortality. Methods: A retrospective analysis of the consecutive operated and non-operated admitted cases of GC in TUTH from 2018 to 2019 was done. Patient demographics, disease characteristics, diagnostic modalities and various curative and palliative treatment variables were analyzed. Results: Of the 59 patients, 33 females (56%) outnumbered the 26 males(44%) with a male is to female ratio of 0.7:1. The median age at diagnosis was 56 years with younger than 60 years comprising 62.7% of the disease. Among all, the most common presenting symptom was abdominal pain followed by jaundice. Onset of first symptoms was within mean duration of 40 days (SD 37.45 days). USG and CT availability (100%) lead to preoperative diagnosis in majority. Curative resection (extended cholecystectomy) was done in 16 (27%).The most common anatomic location of mass was fundic followed by neck. Of the advanced metastatic Ca GB in 30% of cases, the most common site of metastasis was liver. Most cases were adenocarcinoma with mean survival after diagnosis in advanced cases being 4.5 months. Conclusion: CA GB is more common in Nepal, more among females and younger patients often presenting with pain abdomen and jaundice. Most are advanced at the time of diagnosis. Radical surgery can be offered to few patients where the outcome seems reasonably good.