Gallbladder cancer - diagnosis and behavior

Carcinoma of the gallbladder is a relatively rare disease , constituting about 10% of hepatobiliary karntsinomi . In Bulgaria disease, about 300 people a year , most often seen in the sixth and seventh decade of life , dominating women - for women and men is 2.5:1 .

There is a proven link between cholelithiasis ( gall- stone disease) and cancer of the gallbladder , and 74-92 % of patients with gallbladder cancer have bladder stones . Patients with longer duration of cholelithiasis can develop calcification in the wall of the gallbladder - so called porcelain bladder. Is quite possible that the chronic inflammation or persistent infection increases the risk of developing cancer , because 22% of patients have calcified bladder cancer. Cholecystitis and cholelithiasis are more frequent in women, which is directly correlated with a higher incidence of carcinoma . Evidence of these changes were detected in the operated patients , while microscopic examination of the removed gallbladder was demonstrated in varying degrees epithelial dysplasia , atypical hyperplasia or early cancer.

The most common symptoms in cancer of the gallbladder are nonspecific . Pain and discomfort in the right side of ribs are leading . Nausea, vomiting and loss of appetite were observed in 40-64 % of patients , jaundice (yellowing of the skin and mucous membranes ) - in 45% loss of more than 10% by weight - for 37-77 % . Increase of tumor markers ( CEA ) is positive in about 80% of patients in the advanced stage.

Diagnostic method of choice is ultrasound . Small tumors with a size of about 5 mm can be visualized as a polypoidal mass in the lumen of the bladder or local thickening of the wall. The degree of accuracy is about 75%. In case of suspected carcinoma of the gallbladder is necessary to make a computed tomography ( scanner) with a vascular contrast whose degree of confidence varies between 88 and 95 % in individual studies.

At present, the only alternative to radical treatment of this cancer is surgical resection. There are currently no developed selective medicament for the treatment of carcinoma of the gallbladder. Unfortunately, a small portion of the gall bladder carcinomas are otsranimi surgically at the moment of diagnosis. The volume of surgery varies only by removal of the gall bladder to the resection of the surrounding segments of the liver and extrahepatic bile ducts . Even after radical treatment, 5- year survival does not exceed 20%.

In recent years, it suggests that in patients with evidence of gall stones, which have manifested symptoms of the disease is available operably lechenie.Priema that the mechanical action of the stones , and chronic inflammation are sufficient prerequisite for the development of cancer of the gallbladder.

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