PREVALENCE OF CARCINOMA GALLBLADDER IN PATIENTS OF CHOLELITHIASIS

Gall stone is the most common risk factor for carcinoma gall bladder. The aim of this study nds out the prevalence of malignancy in patients with Cholelithiasis. All the radiologically diagnosed cased of cholelithiasis underwent surgery were taken into consideration. All the cases of cholelithiasis operated of in General Surgery Department of VSSIMSAR, Burla were considered for study. The diagnosis conrmed by Ultrasonography /MRCP in Department of Radio diagnosis. Total numbers of patients operated are 347, out of which 279 undergone laparoscopic surgery, 58 cases undergone open surgery and 10 cases converted from laparoscopic to open surgery. Most number of patients belongs to age group 31-40, consisting of 32.85% of total number, followed by age group 41-50, and consisting of 25.07%. A female patient constitutes about 77.81 % of total number. Male: female ratio is 1: 3.5. The mean age of the patients of study group is 41 .71. Mean age of female patients is 41.09 and male is 43.88, p value 0.072 (no signicant deference between mean of female and male). The excised specimens sent for histopathological examination in Department of Pathology, VSSIMSAR, Burla. Out of 347 cases nine cases found to have carcinoma specically adenocarcinoma of gallbladder.

Outcome following Percutaneous Trans-hepatic Biliary Drainage (PTBD) in carcinoma gallbladder: A prospective observational study

Introduction: Percutaneous Biliary drainage (PTBD) is required as palliation and optimization for surgery or chemotherapy in carcinoma gallbladder (GBC) but may be associated with complications. We aimed to study the outcomes, complications and changes in quality of life in patients with GBC undergoing PTBD. Methods: A prospective study from July 2018 to December 2019 in patients of GBC presenting with obstructive jaundice was done. Patients planned for PTBD were included in the study. The progression of disease, complications of PTBD, re-interventions, effects on initiation or completion of chemotherapy, surgical resection or intervention, overall survival was recorded. Quality of life (QoL) was assessed using SF–36 questionnaire before and after 4-6 weeks of intervention. Results: Of 160 patients assessed for inclusion, 60 (mean age: 53.7 ± 10.95 years, 27 (45 %) males) were eventually included. Eleven patients (18.3%) had metastatic disease at presentation. Of 60 patients undergoing PTBD, none had immediate procedure related complications, 41(68 %) patients had at-least one and 18 (30%) patients had more than one complication. The most common complication was peri-catheter bile leak (41.6%) followed by catheter dislodgement (30 %), blockage (23.3 %) and bleeding (10 %). Re-intervention was required in 32 (53 %) of patients. There was a significant decrease in QoL after PTBD (P<0.0001). Median survival after PTBD was 12 weeks.Conclusion: The high technical success of PTBD does not translate into the improvement of QoL, survival, and curative surgical treatment.

Silent and formidable foe: neuroendocrine tumours of the gallbladder

Neuroendocrine neoplasms of the gallbladder occur infrequently, with the diagnosis being incidental in most cases. We present a case of an 81-year-old African American woman who initially presented with acute suppurative cholecystitis, found on pathology to have a moderately differentiated infiltrating adenocarcinoma. A partial hepatic resection with periportal lymph node dissection was planned which was subsequently aborted intraoperatively due to the presence of diffuse carcinomatosis. Pathology of the cancerous lesions revealed neuroendocrine carcinoma. Gallbladder neuroendocrine tumours demonstrate no specific clinical features. Given its often late presentation, neuroendocrine tumours of the gallbladder pose a therapeutic and prognostic challenge.

Frequency of gall bladder carcinoma in cholecystectomies for symptomatic cholelithiasis

It was a Letter to the Editor to find out the frequency of carcinoma gall bladder in patients which were presented with symptomatic cholelithiasis. Carcinoma of the gallbladder is a rear malignancy with 5 year survival rate of 5%. Carcinoma gall bladder is the most common billiary tract malignancy, it is also 5th most common in gastrointestinal malignancies 1. In Pakistan the incidence of carcinoma gallbladder among patients having symptomatic cholelithiasis is 6 to 28%2. Patients with symptomatic gall stones had more risk for developing carcinoma gallbladder as compared to asymptomatic gall stones. Large stones in cholelithiasis are more dangerous than small stones as stone size reaches >3cm risk increases upto 10 fold. Gallbladder polyps >10mm, calcified(porcelain) gallbladder, choledochal cyst, seclerosing cholangitis, anomalous pancreaticobillary junctions and exposure to carcinogens are other risk factors3. Continuous...