1. [Diagnosis and surgical treatment of cancer of the gallbladder and extrahepatic bile ducts].
- Author
-
Nikhinson RA, Dykhno IuA, and KryzhanovskiI AI
- Subjects
- Adenocarcinoma diagnosis, Adenocarcinoma diagnostic imaging, Adult, Aged, Aged, 80 and over, Bile Duct Neoplasms diagnosis, Bile Duct Neoplasms diagnostic imaging, Cholangiography, Cholangiopancreatography, Endoscopic Retrograde, Cholecystectomy, Female, Gallbladder Neoplasms diagnosis, Gallbladder Neoplasms diagnostic imaging, Humans, Lymph Node Excision, Male, Middle Aged, Palliative Care, Adenocarcinoma surgery, Bile Duct Neoplasms surgery, Gallbladder Neoplasms surgery
- Abstract
Data on 148 cases of cancer of the gallbladder and extrahepatic bile ducts were studied. Jaundice proved the cardinal symptom. No clear-cut clinical picture of the disease was identified. Diagnostic procedure should start with ultrasonography. Cholangiectasia and the enlarged pancreatic head make the case for fiber bronchoscopy and hypotonic duodenography. Cancer-negative patients should further undergo transcutaneous transhepatic cholangiography and, if proving still negative, retrograde cholangiopancreatography. Resection of bile ducts with simultaneous lymphadenectomy is considered radical. The authors suggest a surgical procedure for cancer of the gallbladder which includes resection of the liver, hepatico-choledoctomy and cholecystectomy with formation of cholangio-jejuno-anastomosis using disposable transhepatic drains. Recanalization of bile ducts by transhepatic drain is considered optimal for palliation. Survival depends upon extent of surgery and level of bile duct obstruction.
- Published
- 1990