Das Gallenblasenkarzinom als Zufallsbefund nach Cholezystektomie

Abstract

Unsuspected Carcinoma of the Gallbladder following Cholecystectomy In 36 out of 123 patients with gallbladder cancer who were treated between 1973 and 2000 in the Vogtlandklinikum Plauen, the diagnosis was put only by postoperative histological investigation. 22 patients were diagnosed as stage I and II, and 14 were assigned to the prognostically unfavorable stages III and IV. 15 patients were provided for a radical second operation (7 patients in stage I/II, 8 patients in stage III). Only 5 patients in stage I/II and 2 patients in stage III/IV survived for a longer time than 2 years. The inadequate possibilities of early diagnosis remain the decisive problem in the treatment of gallbladder cancer. An extended diagnostic could improve the prognosis in risk patients (female patients of higher age, multiple or large gallstones, long symptomatic gallstone suffering). Because the operation represents the only curative chance, a radical second operation is indicated in the case of an incidental diagnosis. Extensive resections should only be carried out if the possibility of a curative operation is given.