Palliation Dominates Curative Resection in Management of Carcinoma Gallbladder

Introduction: Gallbladder cancer is one of the most lethal carcinomas and continues to pose many challenges to surgeons for being the most common cancer of the biliary tract and is characterized by an abysmal prognosis, especially when diagnosed at an advanced stage, owing to its aggressive behaviour and limited therapeutic options. Palliation remains the goal in most of these patients. The objectives of this study were to outline the pattern of presentation of gallbladder carcinoma at our center and to explore the form of treatment received by the patients. Methods: This is a retrospective analysis of diagnosed cases of carcinoma gallbladder managed in the Department of Surgical Gastroenterology, Tribhuvan University Teaching Hospital from October 2021 to September 2023. The pattern of presentation and modality of treatment offered, either curative resection or palliative therapy, were explored. Results: Among 71 cases, the median age of presentation of carcinoma gallbladder was 62 years. Altogether 64.8% were female and 35.2% male. Pain was the most common presentation (53.5%) and jaundice accounted for 38% of the presentation. Only 28.2% underwent curative resection, radical cholecystectomy being the most frequently performed surgery. In contrast, 71.8% received palliative care. Five cases were lost to follow-up and one-year survival among the resected cases was 93.33% who had completed at least one year follow-up. Conclusions: Gallbladder carcinoma remains a highly aggressive malignancy, often diagnosed at an advanced stage due to its non-specific symptoms. The majority of patients present with unresectable disease, requiring palliative management, with only a small proportion being eligible for curative surgery