Evaluation of cancers of the biliary tracts.
10.2185/jjrm.35.80
- VernacularTitle:当院における胆道悪性しゅよう手術例の検討
- Author:
Tomoo SHIRAKURA
;
Tomio OCHI
;
Eiichi TERASHIMA
- Publication Type:Journal Article
- From:Journal of the Japanese Association of Rural Medicine
1986;35(1):80-90
- CountryJapan
- Language:Japanese
-
Abstract:
During Nov. 1978 and Jul. 1985, we had operated 27 cases of malignant tumors of biliary tracts, namely 16 cases of gallbladder cancers, 9 bile duct cancers, one gallbladder sarcoma and one metastatic tumor of gallbladder from gastric cancer.
The average age of the patients is 70 years old and the ratio of man and woman is 1 to 2.2 in gallbladder cancers and 5 to 4 in bile duct cancers.
Regarding to the diagnostic approach to these diseases, excretery or indirect cholangiographies (OC, DIC) were not useful, but ultrasonic scanning (US) was so effective that we were able to diagnose 2 cases of early gallbladder cancers and get important views in all others.
In 5 cases which we could diagnose as gallbladder cancer preoperatively, only one was resectable to be healthy now. 5 cases diagnosed samely while the operation were all unresectable for the tumors had extremely advanced. In the rest 6 cases diagnosed postoperatively, 5 were now healthy during 19 and 84 months after operation.
All of the bile duct cancer patients were recognized jaundice clinically. 8 patients were diagnosed as cancer by method of direct cholangiography (PTC, ERCP) and seven were resected resulting that five are now surviving for 7 and 67 months after operation. 3 of them presented infiltration to gallbladder and or pancreas, but are alive over three years.
According to these facts and in order to find early or resectable cancers of biliary tract, we began mass screening using US for the inhabitants and have found, for only two years, 1 case of liver metastatic tumor from gastric cancer, 19 cases of asymptomatic gall stones and 4 cases of polypoid lesions of the gallbladder.
Now a 53 year old man who was found an early cancer of the gallbladder ultrasonographically, was examined for electron microscopic observation. Summarily, almost of the cancer cells are resembling each others without goblet and Paneth cells, and surrounded with basement membrane.
Intracellulary, there are abundant organelles and secretery granules. Golgi apparatuses are extremely developed and GERLs are also seen frequently.
