Gallbladder Cancer Presenting with Jaundice: Uniformly Fatal or Still Potentially Curable?

Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract
Thuy B TranGeorge A Poultsides

Abstract

Jaundice as a presenting symptom of gallbladder cancer has traditionally been considered to be a sign of advanced disease, inoperability, and poor outcome. However, recent studies have demonstrated that a small subset of these patients can undergo resection with curative intent. Patients with gallbladder cancer managed surgically from 2000 to 2014 in 10 US academic institutions were stratified based on the presence of jaundice at presentation (defined as bilirubin ≥4 mg/ml or requiring preoperative biliary drainage). Perioperative morbidity, mortality, and overall survival were compared between jaundiced and non-jaundiced patients. Of 400 gallbladder cancer patients with available preoperative data, 108 (27%) presented with jaundice while 292 (73%) did not. The fraction of patients who eventually underwent curative-intent resection was much lower in the presence of jaundice (n = 33, 30%) than not (n = 218, 75%; P < 0.001). Jaundiced patients experienced higher perioperative morbidity (69 vs. 38%; P = 0.002), including a much higher need for reoperation (12 vs. 1%; P = 0.003). However, 90-day mortality (6.5 vs. 3.6%; P = 0.35) was not significantly higher. Overall survival after resection was worse in jaundiced patients (median ...Continue Reading

References

Jan 1, 1997·Surgery·C A RedaelliH U Baer
Nov 14, 2002·The European Journal of Surgery = Acta Chirurgica·László Nehéz, Roland Andersson
Mar 3, 2004·Annals of Surgical Oncology·William G HawkinsYuman Fong
Nov 14, 2006·European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·K S Goonetilleke, A K Siriwardena
Jul 17, 2007·Annals of Surgical Oncology·Anil K AgarwalRajeev Uppal
Nov 6, 2008·Annals of Surgical Oncology·Michael D'AngelicaWilliam R Jarnagin
Jul 30, 2009·Annals of Surgery·Pierre A ClavienMasatoshi Makuuchi
Feb 25, 2010·Annals of Surgical Oncology·Stephen B Edge, Carolyn C Compton
Apr 15, 2011·Annals of Surgery·Hideki NishioMasato Nagino
Apr 26, 2011·European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·J M RegimbeauO Farges
Jun 24, 2011·The Journal of Immunology : Official Journal of the American Association of Immunologists·Steven C KatzRonald P Dematteo
Apr 23, 2013·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Steven M StrasbergCarolyn Phillips
Apr 1, 2014·The Surgical Clinics of North America·Jessica A Wernberg, Dustin D Lucarelli

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Citations

Mar 4, 2018·Current Oncology Reports·Mohammad Yahya Zaidi, Shishir K Maithel
Aug 16, 2017·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Savio G Barreto, Parul J Shukla
Jun 2, 2018·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Jeffery ChakedisTimothy M Pawlik
Feb 4, 2021·Current Problems in Surgery·T Peter KinghamMichael I D'Angelica
Feb 20, 2021·ANZ Journal of Surgery·Marianne F T WietsmaThomas J Hugh
Feb 24, 2021·Langenbeck's Archives of Surgery·Rahul K ChaudharyMasakazu Yamamoto
Apr 29, 2020·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Elise A J de Savornin LohmanPhilip R de Reuver

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