| Popis: |
To identify clinical and pathologic differences between nonadvanced (resectable by cholecystectomy) gallbladder adenocarcinomas (GBA) and advanced (nonresectable) GBA.Twenty-nine cases of GBA were divided into two groups. Patients in group A (n = 15) underwent complete tumor resection by cholecystectomy, and those in group B (n = 14), incomplete or no resection of the tumor. Clinical (age, sex, pain, jaundice, weight loss, abdominal mass, fever), biological (anemia, hypoalbuminemia, cholestasis-cytolysis), diagnostic (ultrasound, intraoperative, postoperative) and pathologic (tumor size and differentiation status) aspects were compared in the two groups.Clinical and biological factors showed no significant differences between the two groups. Overall effectiveness of GC diagnosis before the postoperative pathologic examination was 6.7% in group A and 57.1% in group B (p0.001). Advanced tumors (T3-T4) were found in group B, and nonadvanced tumors in group A (T1-T2, 66.7%). In group B well-differentiated tumors (10 cases) predominated, whereas poorly-differentiated tumors predominated in group A (19 cases, p0.01).The preoperative diagnosis of GBA is difficult, except in advanced cases. No clinical differences exist between completely resected and nonresectable tumors. Resected tumors are usually a postoperative pathologic finding, and are usually nonadvanced and well differentiated. |
