Curative intent radical cholecystectomy followed by hyperthermic intraperitoneal chemotherapy in ruptured intraductal papillary neoplasm of gallbladder with invasive carcinoma

Abstract

Gallbladder cancer has a poor prognosis, especially in peritoneal carcinomatosis related to perforation of the gallbladder followed by bile spillage. Previously, curative-intent treatment was not considered in carcinomatosis from cancer of the biliary tract. A 72-year-old male was referred to the hospital with a perforated gallbladder cancer. Intraoperatively, the tumor was confined to the gallbladder and liver. We presented a case of intention-to-curative resection of perforated gallbladder cancer followed by intraoperative hyperthermic intraperitoneal chemotherapy.

Cytoreductive Surgery and HIPEC for Regionally Advanced Gallbladder Cancer: a Case Report

“…There is ongoing debate regarding optimal treatment modality of GBC. It is often treated with palliative chemotherapy, but treatment options include curative or palliative chemotherapy, radiotherapy and surgical resection [3,[10][11][12][13]. Surgical management ranges from cholecystectomy alone to complete CRS [3,[10][11][12][13].…”

“…It is often treated with palliative chemotherapy, but treatment options include curative or palliative chemotherapy, radiotherapy and surgical resection [3,[10][11][12][13]. Surgical management ranges from cholecystectomy alone to complete CRS [3,[10][11][12][13]. Some studies have indicated that more aggressive resection achieves longer survival time compared to cholecystectomy alone, and we have presented a case where the survival time after CRS with HIPEC is almost 3 years longer than the median survival time for GBC [12,14].…”

“…CRS with HIPEC has demonstrated improved long-term survival for patients with various peritoneal malignancies, including colorectal cancer, appendiceal and primary pseudomyxoma peritonei [3][4][5]15]. However, limited data exists regarding its use in GBC with peritoneal metastasis, with only a handful of cases described in the literature [3][4][5]15].…”

“…CRS with HIPEC has demonstrated improved long-term survival for patients with various peritoneal malignancies, including colorectal cancer, appendiceal and primary pseudomyxoma peritonei [3][4][5]15]. However, limited data exists regarding its use in GBC with peritoneal metastasis, with only a handful of cases described in the literature [3][4][5]15]. Randle et al presented 5 patients who underwent CRS with HIPEC for GBC with peritoneal metastases and reported a 30% 3-year survival rate and median survival time of 22.4 months after CRS [15].…”

“…Gallbladder cancer (GBC) is often diagnosed at an advanced stage, resulting in a poor prognosis, with a median survival of 1 year [1,2]. Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) has potential to treat peritoneal metastases; however, it is not commonly performed in GBC [3][4][5]. We present a case of GBC with peritoneal metastases in a 60-year-old male who was successfully treated with complete CRS and HIPEC and survived for 4 years following diagnosis.…”