1.Adenocarcinoma of gallbladder with chondrosarcomatous component: report of a case.
Hong-fang ZHENG ; Qiu-jing SONG ; Dan-hua SHEN
Chinese Journal of Pathology 2006;35(12):770-770
Adenocarcinoma
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metabolism
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pathology
;
surgery
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Aged
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Cholecystectomy
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Chondrosarcoma
;
metabolism
;
pathology
;
surgery
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Female
;
Gallbladder
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chemistry
;
pathology
;
surgery
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Gallbladder Neoplasms
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metabolism
;
pathology
;
surgery
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Humans
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Immunohistochemistry
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Keratin-3
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metabolism
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S100 Proteins
;
metabolism
2.Natural Course and Treatment Strategy of Gallbladder Polyp.
The Korean Journal of Gastroenterology 2009;53(6):336-340
The polypoid lesions of gallbladder have explosively increased with enhanced feasibility of transabdominal ultrasonography. Most of small polyps less than 10 mm are benign and remain static for a long period. In small polyps, three to six month intervaled ultrasonography is warranted in the initial follow-up, but the duration of follow-up period is not clarified. The polypoid lesions larger than 10 mm show a quite different feature. They showed a remarkable risk of malignancy (34-88%) and should be treated by surgery. Furthermore, age more than 50 years and combined gallstone are important factors predicting malignancy in polypoid lesions of gallbladder. In addition, other factors including solitary polyp and the presence of symptoms are considered as risk factors. Laparoscopic cholecystectomy is a golden standard therapy for these polyps unless the suspicion of malignancy is high. The gallbladder polyps remain a problem of concern to both doctors and patient with the worry of malignancy. Thus, the comprehensive understanding of natural coruse of gallbladder polyp and risk factors of malignancy should be kept in mind.
Cholecystectomy, Laparoscopic
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Gallbladder Diseases/classification/*pathology/surgery
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Gallbladder Neoplasms/diagnosis
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Humans
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Polyps/classification/*pathology/surgery
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Risk Factors
3.Primary keratinizing squamous cell carcinoma of the gallbladder: report of a case.
Wen-mang XU ; Xia LI ; Qi-chan HU ; Shu-ling SONG ; Li WANG ; Yuan-yuan WANG
Chinese Journal of Pathology 2012;41(12):853-854
Aged
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Carcinoma, Squamous Cell
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pathology
;
surgery
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Cholecystectomy
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Gallbladder Neoplasms
;
pathology
;
surgery
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Humans
;
Male
4.A Case of Ciliated Foregut Cyst of the Gallbladder.
Ji Eun HAN ; Myung Hwan NOH ; Woo Jae KIM ; Dong Kyun KIM ; Hwa Seung NAM ; Mee Sook NOH ; Guan Woo KIM
The Korean Journal of Gastroenterology 2016;67(1):49-53
Congenital cysts of the gallbladder are extremely rare, hence only a few ciliated foregut cysts of gallbladder have been reported. We report a case of a 20-year-old woman presenting with mild right upper quadrant abdominal discomfort, with normal levels of serum bilirubin and liver function tests. Abdominal ultrasonography revealed a well-defined cystic mass measured about 2 cm attached to the neck of gallbladder, with internal echogenic debris suggesting a complicated cyst, such as a hemorrhagic cyst. Abdominal computed tomography and magnetic resonance cholangiopancreatography revealed similar findings. Laparoscopic cholecystectomy showed a slightly distended gallbladder. The size of cyst on the neck was 1.6x1.2 cm, and it contained mucosa lined by ciliated pseudostratified columnar epithelium and underlying smooth muscle layers. Histopathology identified a ciliated foregut cyst of gallbladder.
Abdomen/diagnostic imaging
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Cholangiopancreatography, Magnetic Resonance
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Cholecystectomy, Laparoscopic
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Cysts/diagnostic imaging/pathology/surgery
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Female
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Gallbladder/pathology/surgery
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Gallbladder Diseases/*diagnosis
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Humans
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Tomography, X-Ray Computed
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Ultrasonography
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Young Adult
5.Torsion of the Gallbladder: Report of a Case.
Yong Pil CHO ; Hee Jeong KIM ; Seung Mun JUNG ; Gil Hyun KANG ; Myoung Sik HAN ; Hyuk Jai JANG ; Yong Ho KIM ; Sung Gyu LEE
Yonsei Medical Journal 2005;46(6):862-865
Torsion of the gallbladder is a rare entity that is difficult to diagnose preoperatively. The condition occurs most often in the elderly. Although its etiology is unknown, a constant finding is the presence of the gallbladder on a mobile mesentery (floating gallbladder). Torsion, or volvulus, of the gallbladder occurs when it twists axially, with the subsequent occlusion of bile and/or blood flow. Herein, a case of torsion of the gallbladder is presented where preoperative computed tomographic scan and laparoscopy were successfully used to diagnose and treat this condition without the usual requirement of open exploration. Given the possibility of laparoscopic cholecystectomy and the increasing incidence with which torsion of the gallbladder is being witnessed today, the importance of a preoperative computed tomographic scan is emphasized when there is a high index of clinical suspicion.
Torsion/radiography/surgery
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Tomography, X-Ray Computed
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Humans
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Gallbladder Diseases/pathology/*radiography/*surgery
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Female
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Cholecystectomy, Laparoscopic
;
Aged, 80 and over
6.Analysis of Prognostic Factors after Curative Resection for Gallbladder Carcinoma.
Joon Seong PARK ; Dong Sup YOON ; Kyung Sik KIM ; Jin Sub CHOI ; Woo Jung LEE ; Hoon Sang CHI ; Byong Ro KIM
The Korean Journal of Gastroenterology 2006;48(1):32-36
BACKGROUND/AIMS: Despite the development in diagnostic tools, gallbladder carcinoma is often diagnosed at an advanced stage. Therefore, early diagnosis and radical resection are most important factors for the prognosis of gallbladder carcinoma. However, prognostic factors after radical resection of gallbladder carcinoma have not been well identified. The aim of this study was to evaluate the prognostic factors of gallbladder carcinoma after curative resection. METHODS: We reviewed the records of the 115 patients with gallbladder carcinoma who underwent curative surgery between 1989 and 2004 at Yonsei University Medical Center (YUMC). The relationship between survival and clinicopathological variables was assessed. RESULTS: In 311 patients presenting with gallbladder carcinoma, 195 patients (62.5%) were radically resected. Among 195 patients, 80 patients were excluded because of incomplete clinicopathologic data and unsatisfactory follow-up. The 5 year overall survival rate was 36.0%, and disease free 5 year survival rate was 3.9%. Univariate analysis showed that survival was closely related to gross morphology, depth of tumor invasion, lymph node metastasis and preoperative serum CA19-9 level. Three significant factors identified by multivariate analysis were depth of tumor invasion, gross morphology, and preoperative serum CA19-9 level. CONLUSIONS: Depth of tumor invasion, gross morphology, and preoperative serum CA19-9 level are independent significant prognostic factors of resectable gallbladder carcinoma.
Aged
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Carcinoma/mortality/secondary/*surgery
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Female
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Gallbladder Neoplasms/mortality/pathology/*surgery
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Humans
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Lymphatic Metastasis
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Male
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Middle Aged
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Prognosis
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Survival Rate
7.The effect of single incision laparoscopic cholecystectomy on systemic oxidative stress: a prospective clinical trial.
Ilhan ECE ; Bahadir OZTURK ; Huseyin YILMAZ ; Serdar YORMAZ ; Mustafa ŞAHIN
Annals of Surgical Treatment and Research 2017;92(4):179-183
PURPOSE: Single incision laparoscopic cholecystectomy (SILC) has become a more frequently performed method for benign gallbladder diseases all over the world. The effects of SILC technique on oxidative stress have not been well documented. The aim of this study was to evaluate the effect of laparoscopic cholecystectomy techniques on systemic oxidative stress by using ischemia modified albumin (IMA). METHODS: In total, 70 patients who had been diagnosed with benign gallbladder pathology were enrolled for this prospective study. Twenty-one patients underwent SILC and 49 patients underwent laparoscopic cholecystectomy (LC). All operations were performed under a standard anesthesia protocol. Serum IMA levels were analysed before operation, 45 minutes and 24 hours after operation. RESULTS: Demographics and preoperative characteristics of the patients were similiar in each group. The mean duration of operation was 37.5 ± 12.5 and 44.6 ± 14.3 minutes in LC and SILC group, respectively. In both groups, there was no statistically significant difference in hospital stay, operative time, or conversion to open surgery. Operative technique did not effect the 45th minute and 24th hour IMA levels. However, prolonged operative time (>30 minutes) caused an early increase in the level of IMA. Twenty-fourth hour IMA levels were not different. CONCLUSION: SILC is an effective and safe surgical prosedure for benign gallbladder diseases. Independent of the surgical technique for cholecystectomy, the prolonged operative time could increase the tissue ischemia.
Anesthesia
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Cholecystectomy
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Cholecystectomy, Laparoscopic*
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Conversion to Open Surgery
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Demography
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Gallbladder
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Gallbladder Diseases
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Gallstones
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Humans
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Ischemia
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Laparoscopy
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Length of Stay
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Methods
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Operative Time
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Oxidative Stress*
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Pathology
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Prospective Studies*
8.Role of radical resection in patients with gallbladder carcinoma and jaundice.
Fei-ling FENG ; Chen LIU ; Bin LI ; Bai-he ZHANG ; Xiao-qing JIANG
Chinese Medical Journal 2012;125(5):752-756
BACKGROUNDGallbladder carcinoma (GBC) is a commonly-seen malignancy of the biliary tract characterized by difficult early diagnosis, rapid growth, early metastasis, and poor prognosis. Nearly half of GBC patients also have jaundice, which is a mark of the advanced stage of GBC. The role of radical resection in patients of gallbladder carcinoma with jaundice is still a matter of uncertainty, which we attempted to clarify in this study.
METHODSTotally, 251 GBC patients who received treatment at the Eastern Hepatobiliary Surgery Hospital (EHBH) from December 2002 to January 2010 were recruited into this study. We divided them into group A (jaundice group, n=117) and group B (non-jaundice group, n=134). Clinical records and follow-up data were collected and retrospectively analyzed in both groups.
RESULTSCompared with group A, patients in group B had a longer median survival time ((6.0±0.5) months vs. (15.0±2.6) months, P<0.01). Even in patients with stage III or stage IV GBC, the median survival time in patients without jaundice (n=111), was still longer than that in patients with jaundice (n=116) (P<0.01). The radical resection rate was lower in group A patients than in group B patients with stage III or stage IV GBC; 31.9% vs. 63.1%. However, the median survival time of patients undergoing radical resection did not show a statistical difference between jaundice patients and non-jaundice patients; (12.0±4.3) months vs. (18.0±3.0) months (P>0.05).
CONCLUSIONSGBC with jaundice usually implies advanced stage disease and a poor prognosis for the patients. However, our findings indicate that as long as the patient's condition allows, radical resection is still feasible for GBC patients with jaundice, and may achieve a prognosis close to those GBC patients without jaundice.
Adult ; Aged ; Aged, 80 and over ; Carcinoma ; mortality ; pathology ; surgery ; Female ; Gallbladder Neoplasms ; mortality ; pathology ; surgery ; Humans ; Jaundice ; pathology ; Male ; Middle Aged
9.Histopathologic Analysis of Adenoma and Adenoma-related Lesions of the Gallbladder.
Seung Ho LEE ; Dal Sik LEE ; Il Young YOU ; Won Joong JEON ; Seon Mee PARK ; Sei Jin YOUN ; Jae Woon CHOI ; Rohyun SUNG
The Korean Journal of Gastroenterology 2010;55(2):119-126
BACKGROUND/AIMS: In order to determine the malignant potential of gallbladder adenoma for progression to carcinoma, we evaluated the histopathologic features of adenoma and adenoma-related lesions on cholecystectomized specimens. METHODS: Among 1,847 cholecystectomized specimens, 63 specimens from 26 benign adenomas, 9 carcinomas in situ (CIS), and 28 invasive carcinomas were selected. A pathologist reviewed all specimens and selected benign adenomas, CIS in the adenoma, and adenoma residue in invasive carcinomas. Adenomas and adenoma-related lesions were classified according to morphology (tubular, tubulopapillary, and papillary) and the consisting epithelium (biliary, pyloric metaplasia, and intestinal metaplasia). The age and the size of the benign adenomas and carcinomas in the adenoma were also compared. RESULTS: Adenoma and adenoma-related lesions were found in 34 out (1.8%) of all resected gallbladder. Among 9 CIS and 28 invasive carcinomas, adenoma-related lesions were detected in 7 and 1 case, respectively. All eight carcinomas arising in the adenoma were well-differentiated solitary tumors. The diameters of the carcinomas in the adenoma were, on average, larger than that of the benign adenomas (1.8 cm vs. 0.9 cm, p=0.01). The patients with carcinomas in the adenoma were, on average, older than those with benign adenomas, although the difference was insignificant (57 years vs. 47 years, p=0.09). The morphology and consisting epithelium did not differ between the benign adenomas and carcinomas in the adenoma. The malignant transformation occurred in 23.5% of adenomas. CONCLUSIONS: Gallbladder adenoma is a rare disease, although malignant transformation occurs frequently. Adenoma is a precancerous lesion and the adenoma-carcinoma sequence is one of the gallbladder cancer carcinogenesis.
Adenoma/epidemiology/*pathology/surgery
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Adult
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Age Factors
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Aged
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Carcinoma/epidemiology/pathology/surgery
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Cell Transformation, Neoplastic
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Cholecystectomy
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Cystadenoma/epidemiology/pathology/surgery
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Female
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Gallbladder Neoplasms/epidemiology/*pathology/surgery
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Gallstones/complications
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Humans
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Male
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Middle Aged
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Neoplasm Invasiveness
10.Analysis of diagnosis and treatment for 45 patients with gallbladder cancer.
Zong-jing CHEN ; Hong-qi SHI ; Qi-tong SONG
Chinese Journal of Oncology 2011;33(6):475-476
Adenocarcinoma
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diagnosis
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pathology
;
surgery
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Adenocarcinoma, Mucinous
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diagnosis
;
pathology
;
surgery
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Adult
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Aged
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Carcinoma, Squamous Cell
;
diagnosis
;
pathology
;
surgery
;
Cholecystectomy
;
methods
;
Female
;
Follow-Up Studies
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Gallbladder Neoplasms
;
diagnosis
;
pathology
;
surgery
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Humans
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Male
;
Middle Aged
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Neoplasm Staging
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Retrospective Studies
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Survival Rate