Avtor/Urednik		Sojar, Valentin; Trotovšek, Blaž; Tomažič, Aleš; Stanisavljevič, Dragan
Naslov		Rak žolčnika
Prevedeni naslov		Gallbaldder carcinoma
Tip		članek
Vir		In: Jelenc F, editor. Zbornik simpozija Kirurgija žolčnika in žolčevodov; 2003 okt; Ljubljana. Ljubljana: Klinični center, Klinični oddelek za abdominalno kirurgijo,
Leto izdaje		2003
Obseg		str. 132-7
Jezik		slo
Abstrakt		Background. Carcinoma of the gallbladder is a tumour with a dismal prognosis and 5-years overall survival rate less than 5%. Among the tumours of the gastrointestinal tract it is fifth in the row and its incidence is approximately 1.2/105. Tumour occurs more often (2-6 times) in women and in people over 50 years old (90%). According to the Slovenian Registry of Cancer for year 1998 the incidence of gallbladder carcinoma was 2. 7/105 and it occurred 4 times more often among women. The most important risk factors for development of gallbladder carcinoma are: bile stones, chronic inflammation and polyps of the gallbladder. Carcinoma of the gallbladder develops in only 2-3% of the patients with bile stones. When discovered, carcinoma has already invaded the liver in 60%, regional lymph nodes in 45% and the other surrounding organs in 40%. Carcinoma is at time of diagnosis already dissem inated in distant organs in 20%. Only in 10% of the patients it is confined to the gallbladder wall. Before the routine use of the ultrasound, computed tomography and tumour markers the disease was discovered preoperatively in 10% versus 90% today. Percutaneous biopsy for diagnostic is not recommended. TNM classification and staging of the disease is important for the decision of the modality of treatment. Conclusions. For TNM stage I gallbladder carcinoma, simple cholecystectomy is sufficient. When stage 11-IVa is discovered, "en block" resection of gallbladder, liver segments 4b and 5, common bile duct and thorough lymphadenectomy is recommended. Regional radiotherapy and intraarterial chemotherapy with Mitomycine are showing promising results. Long-term outcome in patients with gallbladder carcinoma is improving but it is still disappointing.
Deskriptorji		GALLBLADDER NEOPLASMS NEOPLASM STAGING NEOPLASM INVASIVENESS