Scribd Logo
Upload

Welcome to Scribd!

  • CA Gallbladder

    Uploaded by

    blazingdk sri
    9 views37 pages
    1) Carcinoma of the gallbladder is an aggressive malignancy that often presents at an advanced stage leading to poor prognosis. It is more common in Native Americans, Latinos, parts of South America, and North India. It occurs three times as often in women as in men, usually between the ages of 60-70. 2) Risk factors include gallstones over 3cm, gallbladder polyps over 10mm, and porcelain gallbladder. Other potential causes are anomalous pancreaticobiliary junction, primary sclerosing cholangitis, and environmental exposures to nitrosamines and azotoxins. 3) Treatment options range from radical cholecystectomy for early stage to palliative

    Original Description:

    Copyright

    © © All Rights Reserved

    Available Formats

    PPTX, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Report this Document
    1) Carcinoma of the gallbladder is an aggressive malignancy that often presents at an advanced stage leading to poor prognosis. It is more common in Native Americans, Latinos, parts of South America, and North India. It occurs three times as often in women as in men, usually between the ages of 60-70. 2) Risk factors include gallstones over 3cm, gallbladder polyps over 10mm, and porcelain gallbladder. Other potential causes are anomalous pancreaticobiliary junction, primary sclerosing cholangitis, and environmental exposures to nitrosamines and azotoxins. 3) Treatment options range from radical cholecystectomy for early stage to palliative

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pptx, pdf, or txt
    9 views37 pages

    CA Gallbladder

    Uploaded by

    blazingdk sri
    1) Carcinoma of the gallbladder is an aggressive malignancy that often presents at an advanced stage leading to poor prognosis. It is more common in Native Americans, Latinos, parts of South America, and North India. It occurs three times as often in women as in men, usually between the ages of 60-70. 2) Risk factors include gallstones over 3cm, gallbladder polyps over 10mm, and porcelain gallbladder. Other potential causes are anomalous pancreaticobiliary junction, primary sclerosing cholangitis, and environmental exposures to nitrosamines and azotoxins. 3) Treatment options range from radical cholecystectomy for early stage to palliative

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pptx, pdf, or txt
    of 37

    CA GALLBLADDER

    PROF DR V KOPPERUNDEVI UNIT


    DR R SRIDHAR
    POSTGRADUATE
    IGS,RGGGH
    CARCINOMA GB - INTRODUCTION

    • Aggressive malignancy mostly presents in an advanced stage leading to poor prognosis


    • MC in
    • Native americans,Latinos,Chile and in North india
    • 3 times in women than men
    • 6th to 7th decade
    ETIOLOGY

    GALLSTONES POLYP PORCELAIN GB


    >3CM 10 TIMES >10MM 25%RISK 10%RISK

    ANOMALOUS ENVIRONMENTAL
    PRIMARY SCLEROSING
    PANCREATICOBILIARY
    CHOLANGITIS NITROSOMINE,AZOTOULENE
    JUNCTION
    PATHOLOGY

    • Histology
    • MC Adenocarcinoma , subtype papillary – good prognosis
    • Squamous ca due to metaplasia

    • Routes of spread
    • Lymphatics via Lund node,choledochal nodes to hilar nodes
    • Venous
    • Direct spread to liver and beyond
    CLINICAL PRESENTATION

    • Masquerades as benign pathology


    • Rt upper quadrant pain
    • Nausea and vomiting
    • Loss of appetite
    • Loss of weight
    • Abdominal pain
    • Jaundice
    • obstruction
    INVESTIGATIONS

    • ROUTINE INVESTIGATIONS
    • CEA , CA 19 9
    • USG
    • TRIPLE PHASE CT
    • CT CHEST
    • MRCP
    • PET
    INVESTIGATIONS
    TNM STAGING AJCC 8TH EDITION
    MANAGEMENT-INTRAOP PRESENTATION
    POST OP PRESENTATION
    PREOPERATIVE PRESENTATION
    ADVANCED PRESENTATION
    RADICAL CHOLECYSTECTOMY

    • GLENN AND HAY


    • Cholecystectomy + wedge resection of gb fossa depth 2 cm + portal lymph nodes
    EXTENDED RADICAL CHOLECYSTECTOMY

    • MODIFIED GLENN
    • CHOLECYSTECTOMY+WEDGE RESECTION OF GB FOSSA + EXTRAHEPATIC BILE DUCT +
    REGIONAL LYMPHADENOPATHY
    • REGIONAL LYMPHADENOPATHY
    • CYSTIC
    • PERICHOLEDOCHAL
    • POSTERIOR SUPERIOR PANCREATICODUODENAL
    • RETROPORTAL
    • RT CELIAC
    • RT HEPATIC ARTERY
    EXTENDED RADICAL CHOLECYSTECTOMY
    PRINCIPLES OF HEPATIC SURGERY
    PALLIATIVE CARE

    • CELIAC PLEXUS BLOCK


    • ERCP STENTING OR PTBD
    PROGNOSIS

    • T1A 100%
    • T1B,T2 70 %
    • T3,4 20%
    • MEAN SURVIVAL PERIOD 6 months
    • INDEX <5%
    COMPLICATIONS OF CHOLECYSTECTOMY
    STRASBERG CLASSIFICATION OF BILE DUCT INJURY
    BILE LEAK PROTOCOL
    POST CHOLECYSTECTOMY SYNDROME

    • Symptoms of gb disease persisting postoperatively due to other pathology


    • Treat the other cause
    REFERENCES

    • BAILEY AND LOVE 8 TH EDITION


    • SABISTON TEXTBOOK OF SURGERY 20TH EDITION
    • FISCHERS MASTERY OF SURGERY
    • SCHWARTZ PRINCIPLES OF SURGERY 12 TH EDITION
    • NCCN GUIDELINES 2023
    THANK YOU

    You might also like