Extended Cholecystectomy for Gall Bladder Cancer

Objective: To evaluate the clinical profile of patients with gallbladder cancer. Methodology: This is a single institution based retrospective study of patients with gallbladder cancer who presented at College of Medical Sciences and Teaching Hospital, Bharatpur, Chitwan, Nepal. Patients presenting during the two years period from August 2011 to July 2013 were reviewed. Result: Out of 12 patients, 9 were females (75%) and 3 were males (25%), showing female preponderance. Most of the patients (75%) were in age group of 51-70 years. Only one patient (8%) was below 50 years of age. Main symptom was pain associated with anorexia, nausea & vomiting. Major signs were palpable mass, hepatomegaly and jaundice. All the histopathological reports were adenocarcinoma. 8 patients (66.66%) presented with advanced disease and were managed with extended cholecystectomy followed by systemic chemotherapy. Conclusions: Prevalence of gall bladder cancer is higher in females in our series. Most of the patients were in fifth to seventh decade of life and presented in advanced stage. Gallbladder cancer showed association with gallstones. DOI: http://dx.doi.org/10.3126/jonmc.v3i1.10050 Journal of Nobel Medical College Vol.3(1) 2014; 27-30

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Carcinoma of the gall bladder: 8 year experience from a tertiary care centre, Punjab, India

International Surgery Journal ◽

10.18203/2349-2902.isj20192059 ◽

2019 ◽

Vol 6 (6) ◽

pp. 1912

Author(s):

Mohit Sharma ◽

Rachhpal Singh

Keyword(s):

Bladder Cancer ◽

Gall Bladder ◽

Lymph Nodes ◽

Survival Time ◽

Median Survival Time ◽

Median Number ◽

Gall Bladder Cancer ◽

Extended Cholecystectomy ◽

Stage Ivb

Background: Gall bladder carcinoma is the most common malignancy of biliary tract and one of the most aggressive gastrointestinal malignancies. The present study was conducted to know the clinical aspects, results and survival patterns after therapeutic interventions in patients of gall bladder cancer.Methods: The study is retrospective analysis of prospectively collected data of gall bladder cancer patients.Results: In 288 gall bladder cancer patient’s median age was 60 yrs. There were 219 females, 69 males (F:M=3.2:1). Median number of days from the onset of symptoms to presentation was 24.5 days. Majority of patients were stage IVB 162 (56.3%), least were stage I 3(1%). 192 (66.7%) patients received palliative treatment because of unresectable malignancy. 39 (13.5%) patients underwent noncurative surgical intervention. 57 (19.8%) patients underwent extended cholecystectomy. The median number of lymph nodes detected on histopathological examination was 4.5 (range 3-12). 21 patients (36.8%) had positive lymph nodes. Median follow up of all patients was 6 months (1-66 months). 27 (9.4%) patients survived till last date of follow up. Median survival time in groups undergoing extended cholecystectomy, noncurative surgery, chemotherapy alone was 12, 8 and 4 months respectively. The difference in median survival time between the groups was statistically significant, Log rank (Mantel-Cox) χ2=109.78, p=0.00.Conclusions: Carcinoma of the gall bladder predominately affects females. Majority of patients had delayed presentation, stage IVB. Extended cholecystectomy is the only effective treatment to achieve long term survival.

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Laparoscopic Extended Cholecystectomy for Early Gall Bladder Cancer

Journal of Nepal Health Research Council ◽

10.33314/jnhrc.v18i4.2642 ◽

2021 ◽

Vol 18 (4) ◽

pp. 724-728

Author(s):

Dhiresh Kumar Maharjan ◽

Prabin Bikram Thapa

Keyword(s):

Bladder Cancer ◽

Gall Bladder ◽

Tumour Size ◽

Laparoscopic Approach ◽

College Teaching ◽

Laparoscopic Group ◽

Gall Bladder Cancer ◽

P Value ◽

Open Approach ◽

Extended Cholecystectomy

Background: Laparoscopic approach for early gall bladder cancer (T1b and T2) has been seen to have equal or better early outcomes and late outcomes in terms of overall survival rate and recurrence rate.Methods: This is a prospective cross sectional observational study performed including all consecutive patients who were diagnosed with gall bladder cancer by a single surgical team from August 2018 to February 2020 at Kathmandu Medical College Teaching Hospital or referred from outside for completion extended cholecystectomy where laparoscopic cholecystectomy was done in some other centre.Results: The mean age of the patients was 51.01±9.42 years in the laparoscopic extended cholecystectomy (N=10) group and 49.6±8.35 years in the open extended cholecystectomy (N=10) group (p value=0.711). Conversion rate was 20% in laparoscopic group. The operative time was longer in the laparoscopic group (287 +/-66.50 minutes, 120.0 to 446 minutes vs. 200+/-66.50 minutes, 100 to 405.0 minutes; p< 0.004.However, the laparoscopic extended cholecystectomy group showed faster time to oral intake and time to first passage of flatus and had shorter hospital stay by 2.2 days (4.8+/-0.78 days) than open approach 7+/-0.81 days.(p value=0.00).There were no significant differences between the groups in the tumour size (p=0.079) and number of harvested lymph nodes 9.3 (5 to 13) in laparoscopic group vs. 11.2 (8 to 15) in open extended cholecystectomy group (p=0.250).Conclusions: Laparoscopic extended cholecystectomy is feasible in early gall bladder cancer along with achievement of oncological safety.Keywords: Gall bladder cancer; laparoscopic extended cholecystectomy; open extended cholecystectomy

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Jab1-siRNA Induces Cell Growth Inhibition and Cell Cycle Arrest in Gall Bladder Cancer Cells via Targeting Jab1 Signalosome

Anti-Cancer Agents in Medicinal Chemistry ◽

10.2174/1871520619666190725122400 ◽

2020 ◽

Vol 19 (16) ◽

pp. 2019-2033 ◽

Cited By ~ 2

Author(s):

Pratibha Pandey ◽

Mohammad H. Siddiqui ◽

Anu Behari ◽

Vinay K. Kapoor ◽

Kumudesh Mishra ◽

...

Keyword(s):

Cell Cycle ◽

Bladder Cancer ◽

Cell Growth ◽

Gall Bladder ◽

Growth Inhibition ◽

Cell Cycle Arrest ◽

Gall Bladder Cancer ◽

Cell Growth Inhibition ◽

Cycle Arrest ◽

Apoptotic Induction

Background: The aberrant alteration in Jab1 signalosome (COP9 Signalosome Complex Subunit 5) has been proven to be associated with the progression of several carcinomas. However the specific role and mechanism of action of Jab1 signalosome in carcinogenesis of gall bladder cancer (GBC) are poorly understood. Objective: The main objective of our study was to elucidate the role and mechanism of Jab1 signalosome in gall bladder cancer by employing siRNA. Methods: Jab1 overexpression was identified in gall bladder cancer tissue sample. The role of Jab1-siRNA approach in cell growth inhibition and apoptotic induction was then examined by RT-PCR, Western Blotting, MTT, ROS, Hoechst and FITC/Annexin-V staining. Results: In the current study, we have shown that overexpression of Jab1 stimulated the proliferation of GBC cells; whereas downregulation of Jab1 by using Jab1-siRNA approach resulted incell growth inhibition and apoptotic induction. Furthermore, we found that downregulation of Jab1 induces cell cycle arrest at G1 phase and upregulated the expression of p27, p53 and Bax gene. Moreover, Jab1-siRNA induces apoptosis by enhancing ROS generation and caspase-3 activation. In addition, combined treatment with Jab1-siRNA and gemicitabine demonstrated an enhanced decline in cell proliferation which further suggested increased efficacy of gemcitabine at a very lower dose (5μM) in combination with Jab1-siRNA. Conclusion: In conclusion, our study strongly suggests that targeting Jab1 signalosome could be a promising therapeutic target for the treatment of gall bladder cancer.

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Elucidation of the Chemopreventive Role of Stigmasterol Against Jab1 in Gall Bladder Carcinoma

Endocrine Metabolic & Immune Disorders - Drug Targets ◽

10.2174/1871530319666190206124120 ◽

2019 ◽

Vol 19 (6) ◽

pp. 826-837 ◽

Cited By ~ 3

Author(s):

Pratibha Pandey ◽

Preeti Bajpai ◽

Mohammad H. Siddiqui ◽

Uzma Sayyed ◽

Rohit Tiwari ◽

...

Keyword(s):

Cell Cycle ◽

Bladder Cancer ◽

Gall Bladder ◽

Cancer Cells ◽

Caspase 3 ◽

Annexin V ◽

Gall Bladder Cancer ◽

Apoptosis Induction ◽

Bladder Cancer Cells ◽

Hoechst Staining

Background:Plant sterols have proven a potent anti-proliferative and apoptosis inducing agent against several carcinomas including breast and prostate cancers. Jab1 has been reported to be involved in the progression of numerous carcinomas. However, antiproliferative effects of sterols against Jab1 in gall bladder cancer have not been explored yet.Objective:In the current study, we elucidated the mechanism of action of stigmasterol regarding apoptosis induction mediated via downregulation of Jab1 protein in human gall bladder cancer cells.Methods:In our study, we performed MTT and Trypan blue assay to assess the effect of stigmasterol on cell proliferation. In addition, RT-PCR and western blotting were performed to identify the effect of stigmasterol on Jab1 and p27 expression in human gall bladder cancer cells. We further performed cell cycle, Caspase-3, Hoechst and FITC-Annexin V analysis, to confirm the apoptosis induction in stigmasterol treated human gall bladder cancer cells.Results:Our results clearly indicated that stigmasterol has up-regulated the p27 expression and down-regulated Jab1 gene. These modulations of genes might occur via mitochondrial apoptosis signaling pathway. Caspase-3 gets activated with the apoptotic induction. Increase in apoptotic cells and DNA were confirmed through annexin V staining, Hoechst staining, and cell cycle analysis.Conclusion:Thus, these results strongly suggest that stigmasterol has the potential to be considered as an anticancerous therapeutic agent against Jab1 in gall bladder cancer.

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