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Book Details
Abstract
Carcinoma gallbladder is the third most common GI malignancy and the most common biliary tract malignancy in North India. Of all the known risk factors, gallstones are most commonly associated with GBC. Bile stasis and chronic inflammation along with occupational exposure to heavy metals, dietary carcinogens, and radiation exposure have been found to be responsible for the increased incidence of GB neoplasms. Infections with S. typhii and S. paratyphii along with Helicobacter sp. have also been associated with GBC. p 53 and ras gene mutations are strongly associated with GBC. Early diagnosis of GBC still remains a challenge and is often diagnosed as a part of investigations of any other disease. Most GBCs are at advanced stage at presentation. USG and CT scan are the common modes for the preliminary diagnosis of GBC. Surgery remains the key treatment modality and the only hope for long-term survival. A large number of patients present at the unresectable stage of the tumor, and palliation remains the only alternative to ensure better quality of life.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover\r | Front Cover | ||
| Front Matter \r | ia | ||
| ECAB Clinical Update:Gastroenterology/Hepatology | ic | ||
| Copyright | ie | ||
| About the Authors | if | ||
| Contents | ij | ||
| ECAB Clinical Update InformationCarcinoma Gallbladder | i | ||
| Introduction | 1 | ||
| Gallbladder Carcinoma: Epidemiology and Pathogenesis | 4a | ||
| Epidemiology | 6 | ||
| Etiopathogenesis | 8 | ||
| Occult Pancreaticobiliary Reflux | 9 | ||
| Gallbladder Polyp | 11 | ||
| Chronic Cholecystitis | 12 | ||
| Genetic Factors in the Etiology of Gallbladder Cancers | 13 | ||
| Staging and Prognosis | 14 | ||
| Case Studies Gallbladder Carcinoma: Epidemiology and Pathogenesis | 19 | ||
| Case study 1 | 19 | ||
| On Examination | 19 | ||
| Investigations | 19 | ||
| Case study 2 | 20 | ||
| On Examination | 21 | ||
| Investigations | 21 | ||
| Problem-Oriented Approach | 21 | ||
| Acknowledgement | 21 | ||
| Etiopathogenesis and Diagnosis of Gallbladder Cancer | 22 | ||
| Etiological Factors | 23 | ||
| Cholelithiasis: Culprit or a Red Herring? | 23 | ||
| Bacterial Infections | 24 | ||
| Typhoid Carrier State | 25 | ||
| Gallbladder Cancer as a Genetic Disease | 26 | ||
| Congenital Anomalies of Biliary System | 28 | ||
| Miscellaneous Factors Associated With Gallbladder Carcinoma | 29 | ||
| Benign Neoplasms of Gallbladder | 29 | ||
| Dietary and Lifestyle Factors | 29 | ||
| Diagnosis Of Gallbladder Cancer | 29 | ||
| Symptoms and Signs | 29 | ||
| Diagnostic Modalities | 30 | ||
| USG | 30 | ||
| Utility of CT | 32 | ||
| MRI | 34 | ||
| USG-guided FNAC of Gallbladder Mass | 34 | ||
| Staging of Gallbladder Cancer | 34 | ||
| Summary | 36 | ||
| Case Studies Etiopathogenesis and Diagnosis of Gallbladder Cancer | 40 | ||
| Case Study 1 | 40 | ||
| Case Study 2 | 42 | ||
| Surgery in Gallbladder Cancer | 44 | ||
| Diagnosis | 45 | ||
| Is Preoperative Biopsy Required in Gallbladder Cancer? | 47 | ||
| Differentiation of Gallbladder Cancer from Xanthogranulomatous Cholecystitis | 47 | ||
| Overall Presentation | 48 | ||
| Staging Laparoscopy | 49 | ||
| Staging of Gallbladder Cancer | 49 | ||
| Surgical Resection | 49 | ||
| Incidental Pathological Report of Carcinoma | 51 | ||
| Intraoperative Detection of Gallbladder Cancer | 53 | ||
| Port-Site Metastases After Laparoscopic Cholecystectomy-Myth or Reality? | 54 | ||
| If the Tumor is T1b or If There is Bile Spillage at the Time of Cholecystectomy | 54 | ||
| Extended Cholecystectomy in Gallbladder Cancer | 55 | ||
| Extent of Lymph Node Dissection | 55 | ||
| T2 Disease | 56 | ||
| Locally Advanced Disease (T3 & T4 Disease) | 57 | ||
| Major Hepatic Resection in Gallbladder Cancer | 58 | ||
| Is Bile Duct Resection Mandatory in Radical Surgery for Gallbladder Cancer? | 58 | ||
| Vascular Involvement | 60 | ||
| Pancreaticoduodenectomy | 60 | ||
| Palliative Surgery for Gallbladder Cancer | 61 | ||
| Indian Scenario | 61 | ||
| Prevention of Gallbladder Cancer | 62 | ||
| Factors Affecting Survival of Gallbladder Cancer | 63 | ||
| Conclusions | 65 | ||
| Case Studies Surgery in Gallbladder Cancer | 75 | ||
| Case Study 1 | 75 | ||
| Comment | 76 | ||
| Case Study 2 | 76 | ||
| Comment | 77 | ||
| Case Study 3 | 78 | ||
| Comments | 79 | ||
| Case Study 4 | 79 | ||
| Comments | 80 | ||
| Carcinoma Gallbladder: Role of Endoscopy | 81 | ||
| Diagnosis | 82 | ||
| Endoscopic Ultrasound | 83 | ||
| Cholangiography | 83 | ||
| Palliation of Obstructive Jaundice | 83 | ||
| Surgical Bypass Versus Stenting | 83 | ||
| Unilateral Versus Bilateral Stents | 85 | ||
| Plastic Versus Metal Stents | 86 | ||
| Conclusion | 87 | ||
| Case Studies Carcinoma Gallbladder: Role of Endoscopy | 92 | ||
| Case Study 1 | 92 | ||
| Case Study 2 | 94 | ||
| Summary | 96 | ||
| Forthcoming Books | 97 | ||
| PORTAL HYPERTENSION | 97 | ||
| IRRITABLE BOWEL SYNDROME | 98 | ||
| INFLAMMATORY BOWEL DISEASE | 98 | ||
| ALCOHOLIC LIVER DISEASE IN INDIA | 99 | ||
| HEPATIC ENCEPHALOPATHY | 99 |