Comparison of survival of patients with advanced gallbladder cancer undergoing different surgical procedures

Objective: To evaluate the impact of different surgical procedures on survival of patients with advanced gallbladder cancer. Methods: The clinical records and follow-up information from 72 patients who were diagnosed as having advanced gallbladder carcinoma and underwent different surgical procedures including extended radical resection (n = 20), palliative resection (n = 13), internal or external biliary drainage (n = 25) and exploratory laparotomy (n = 14) between January 2000 and December 2009 were retrospectively reviewed. The postoperative complications and the median survival time as well as one-year and two-year survival rates were compared among patients undergoing different surgical procedures. Results: There were 66 patients who were not lost and 6 patients who were lost to follow-up. The 66 patients who were not lost to follow-up included 19 patients in extended radical resection group, 13 patients in palliative resection group, 22 patients in internal or external biliary drainage group, and 12 patients in exploratory laparotomy group. The median survival time of the extended radical resection group was 12 months, which was significantly higher than those of the palliative resection group (4 months), internal or external biliary drainage group (2 months) and exploratory laparotomy group (3 months) (P < 0.05). The one-year and two-year survival rates of the extended radical resection group were 52.6% and 26.3%, respectively, which were also significantly higher than those of the palliative resection group (7.7% and 0.0%), internal or external biliary drainage group (4.5% and 0.0%) and exploratory laparotomy group (0.0% and 0.0%) (P < 0.05). Postoperativecomplications were observed in 6 of the 20 patients in the extended radical resection group. Conclusion: Compared with surgical procedures of palliative resection, internal or external biliary drainage and exploratory laparotomy, the extended radical resection can obviously prolong the survival time of the patients with advanced gallbladder cancer. The extended radical resection should be considered after rigorous screening and clinical assessment, and the postoperative complications should be prevented.