World journal of gastrointestinal surgery · 2025
Bile spillage in incidental gallbladder cancer is not an independent predictor for survival: A multi-institute retrospective cohort study.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
van Dooren Mike, de Savornin Lohman Elise Aj, van der Post Rachel S, Hoogwater Frederik Jh, van den Boezem Peter B, Groot Koerkamp Bas, Erdmann Joris I, de Reuver Philip R
Аннотация
BACKGROUND: Bile spillage occurs more frequently in patients with incidental gallbladder carcinoma (iGBC) and may be associated with poor survival due to presumed high risk of peritoneal seeding.
AIM: To investigate the impact of bile spillage during primary surgery on the survival of patients with iGBC.
METHODS: Medical records of patients with iGBC diagnosed between 2000 and 2019 in 27 Dutch secondary centers and 5 tertiary centers were retrospectively reviewed. Patient medical records were assessed. Predictors for overall survival (OS) were determined using multivariable Cox regression.
RESULTS: Of the 346 included patients with iGBC, 138 (39.9%) had bile spillage, which was associated with higher American Society of Anesthesiologists classification (P = 0.020), cholecystitis (P < 0.001), higher tumor stage (P = 0.005), and non-radical resection (P < 0.001). Bile spillage was associated with poor OS [hazard ratio = 1.97, 95% confidence interval (CI): 1.48-2.63, P < 0.001] with a median OS of 12 months (95%CI: 7-18 months) vs 34 months (95%CI: 14-55 months, P < 0.001). In multivariable analysis, spillage was not an independent prognostic factor for survival (hazard ratio = 1.21, 95%CI: 0.84-1.74, P = 0.313).
CONCLUSION: Although bile spillage correlates with prognostic factors, it lacks independent prognostic significance for survival. Patients with an indication for additional treatment should be promptly referred to a specialized hepatopancreatobiliary center, irrespective of whether bile spillage has occurred.
AIM: To investigate the impact of bile spillage during primary surgery on the survival of patients with iGBC.
METHODS: Medical records of patients with iGBC diagnosed between 2000 and 2019 in 27 Dutch secondary centers and 5 tertiary centers were retrospectively reviewed. Patient medical records were assessed. Predictors for overall survival (OS) were determined using multivariable Cox regression.
RESULTS: Of the 346 included patients with iGBC, 138 (39.9%) had bile spillage, which was associated with higher American Society of Anesthesiologists classification (P = 0.020), cholecystitis (P < 0.001), higher tumor stage (P = 0.005), and non-radical resection (P < 0.001). Bile spillage was associated with poor OS [hazard ratio = 1.97, 95% confidence interval (CI): 1.48-2.63, P < 0.001] with a median OS of 12 months (95%CI: 7-18 months) vs 34 months (95%CI: 14-55 months, P < 0.001). In multivariable analysis, spillage was not an independent prognostic factor for survival (hazard ratio = 1.21, 95%CI: 0.84-1.74, P = 0.313).
CONCLUSION: Although bile spillage correlates with prognostic factors, it lacks independent prognostic significance for survival. Patients with an indication for additional treatment should be promptly referred to a specialized hepatopancreatobiliary center, irrespective of whether bile spillage has occurred.