The prognostic importance of jaundice in surgical resection with curative intent for gallbladder cancer

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• 作者：Xin-wei Yang (22)
  Jian-mao Yuan (23)
  Jun-yi Chen (24)
  Jue Yang (22)
  Quan-gen Gao (23)
  Xing-zhou Yan (22)
  Bao-hua Zhang (22)
  Shen Feng (22)
  Meng-chao Wu (22)
  
  22. Eastern Hepatobiliary Surgery Hospital ; Second Military Medical University ; Changhai Road 225 ; Shanghai ; 200438 ; China
  23. Department of General Surgery ; The First People鈥檚 Hospital of Wujiang affliated Wujiang Hospital of Nantong University ; Suzhou ; China
  24. Department of General Surgery ; Branch of the first People鈥檚 Hospital of Shanghai ; North Sichuang Road 1878 ; Shanghai ; 200081 ; China
  
• 关键词：Gallbladder cancer ; Jaundice ; Curative resection ; Preoperative biliary drainage ; Prognosis
• 刊名：BMC Cancer
• 出版年：2014
• 出版时间：December 2014
• 年：2014
• 卷：14
• 期：1
• 全文大小：712 KB
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  32. The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2407/14/652/prepub
  
• 刊物主题：Cancer Research; Oncology; Stem Cells; Animal Models; Internal Medicine;
• 出版者：BioMed Central
• ISSN：1471-2407

文摘

Background Preoperative jaundice is frequent in gallbladder cancer (GBC) and indicates advanced disease. Resection is rarely recommended to treat advanced GBC. An aggressive surgical approach for advanced GBC remains lacking because of the association of this disease with serious postoperative complications and poor prognosis. This study aims to re-assess the prognostic value of jaundice for the morbidity, mortality, and survival of GBC patients who underwent surgical resection with curative intent. Methods GBC patients who underwent surgical resection with curative intent at a single institution between January 2003 and December 2012 were identified from a prospectively maintained database. Results A total of 192 patients underwent surgical resection with curative intent, of whom 47 had preoperative jaundice and 145 had none. Compared with the non-jaundiced patients, the jaundiced patients had significantly longer operative time (p Conclusions Preoperative jaundice indicates poor prognosis and high postoperative morbidity but is not a surgical contraindication. Gallbladder neck tumors significantly increase the surgical difficulty and reduce the opportunities for radical resection. Gallbladder neck tumors can independently predict poor outcome. PBD correlates with neither a low rate of postoperative intra-abdominal abscesses nor a high survival rate.