Diagnosis and treatment of primary gallbladder carcinoma：A report of 1222 cases        SUN Xue-jun, SHI Jing-sen, WANG Lin,et al. Department of General Surgery , the First Affiliated Hospital of Medical College of Xi’an Jiaotong University , Xi’an 710061 , China
Corresponding  author： SHI Jing-sen, E-mail: shijingsen@163.com
Abstract    Objective    To analyze the clinical characters of primary carcinoma of gallbladder (PCG)，summarize the experience of its diagnosis and treatment and discuss the related factors affecting prognosis. Methods    The clinical data of 1222 cases of PCG from 1956 to 2008 in the First Affiliated Hospital of Medical College of Xi’an Jiaotong University were analyzed retrospectively. The data were processed using statistical methods. Results    There were 636 cases of certain pathological data，of which the adenocarcinoma accounted for 90.7%,the squamous cell carcinoma and the gland squamous cell carcinoma 2.8% and 3.6%，respectively，other species accounting for less. Of the 247 cases under went surgical treatment from 2004 to 2008，the liver bed invasion by the gallbladder carcinoma or the liver metastases were in 152 cases，and the local or distant lymph nodes enlarged were in 107 cases, including 30 cases conformed cancer metastasis，32 cases of abdominal distributed widely. The follow-up data of 267 cases from 2004 to 2008 showed that tumor stage and surgical option had relationship with patient prognosis，while age，gender，histological type，serum CEA and CA19- 9 had nothing to do with prognosis. Survival analysis showed that the higher the Nevin staging curves，the faster the survival curve fall. The 1 to 5 year survival rate and the survival time of the patients with the standard radical surgery treatment were higher than the other forms of treatment. Conclusion    It is difficult to make a definite diagnosis of the early PCG. The associated examination of ultrasonic and CT can be regarded as the routine examination of PCG. The comprehensive treatment based on surgery is the primary treatment for the PCG. The radical resection is effective in prolonging life span and improving prognosis of some patients.