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Abstract: This patient is an elderly male who came to the clinic with right upper abdominal fullness and discomfort for more than half a month. The patient reported that he had gallbladder stones and cholecystitis for a long time, but did not undergo regular treatment such as surgery. The patient reported that he had gallbladder stones and cholecystitis for a long time, but he did not undergo surgery and other regular treatments. This time, he felt that his symptoms continued to worsen, so he came to the clinic, and outpatient ultrasound and CT examination indicated that the gallbladder was occupying, and malignant tumor of gallbladder was considered, along with gallbladder stones and cholecystitis.
Basic information】Male, 62 years old
Disease Type】Gallbladder stones, cholecystitis, gallbladder malignant tumor
Hospital】Liaocheng People’s Hospital
Date of Consultation】November 2021
Treatment plan】Surgical treatment (radical gallbladder cancer surgery) + chemotherapy
Treatment Period】2 weeks of inpatient treatment, half year of outpatient follow-up
Treatment effect] The tumor was radically removed and recovered well after surgery.
I. Initial consultation
This patient came to the clinic because of the discomfort of right upper abdomen fullness and distension. The patient reported that he had been feeling uncomfortable in his right upper abdomen and found gallbladder stones combined with cholecystitis several years ago. This time, the patient felt that her symptoms were worse than before, so she came to the hospital. Ultrasound examination at the outpatient clinic revealed not only gallbladder stones combined with cholecystitis, but also cauliflower-like growths in the gallbladder that were full and growing inward. It was highly suspected that the gallbladder stones had caused malignant tumor of gallbladder, and the patient was admitted to the hospital immediately.
Treatment process
After the patient was admitted to the hospital, tumor markers were checked and CEA and CA199 were found to be significantly elevated, which was highly suspected to be a malignant tumor of the gallbladder. The patient was then given an intensive CT examination, which revealed that the gallbladder was filled with hyperplasia, a condition highly suspicious of malignant tumor of the gallbladder. At the same time, no other distant metastases were found in CT. After communicating with the patient’s family, according to the patient’s current CT report, it was assessed that the gallbladder tumor could be resected and the patient’s physical condition could tolerate the surgery, so the patient and his family agreed to perform the surgery. Then the patient underwent radical surgery for gallbladder cancer under general anesthesia, and the postoperative pathology also confirmed that it was a malignant tumor of gallbladder. After the operation, the patient gradually resumed normal diet and recovered very well after the operation, and was discharged from the hospital when he was hospitalized for 2 weeks, and was asked to follow up the patient for 6 months. Because of the high malignancy of gallbladder malignancy, the patient was ordered to undergo 6 cycles of chemotherapy after surgery. At present, the patient has completed 6 cycles of chemotherapy, and no sign of tumor recurrence was found in the postoperative review.
III. Treatment effect
This patient had a clear diagnosis of malignant gallbladder tumor and underwent radical surgery in time. The surgical effect of radical resection of the tumor was relatively good, and the tumor had been removed radically, and the patient had no other uncomfortable symptoms and reactions. After 6 cycles of postoperative adjuvant chemotherapy, the treatment effect was further consolidated. At present, the patient has been followed up for six months, and the patient has recovered well after surgery, no obvious tumor recurrence has been found, and there is no impact on the patient’s normal life.
IV. Notes
We are glad that the patient’s condition was effectively controlled after the surgical treatment and no uncomfortable symptoms appeared. However, it is recommended that patients should still pay attention to their diet after discharge from hospital, because after surgery, patients’ gastrointestinal tract has undergone certain diversion, so avoid overeating, eating less and more meals, consuming well-digested food and avoiding greasy food. In addition, patients should also review regularly. Usually, after radical surgery for malignant tumors, they should review once in 2 months, and after half a year, it can be changed to once in 3 months. The purpose of review is to detect the recurrence of tumor at an early stage, so as to get better treatment effect.
V. Personal insight
As the living conditions become better and better, the incidence of gallbladder stones is also increasing, thus inducing the incidence of gallbladder malignant tumor to increase as well. However, the occurrence of gallbladder malignant tumor has a certain process, which is often caused by long-term inflammatory stimulation of gallbladder stones. Therefore, when gallbladder stones are combined with cholecystitis, gallbladder stones should be treated early, which can actively prevent the occurrence of gallbladder malignant tumor. As in this case, if laparoscopic cholecystectomy is performed when gallbladder stones and cholecystitis are detected at an early stage, the occurrence of gallbladder malignancy can be prevented and better treatment results can be achieved. Therefore, if you have gallbladder stones combined with cholecystitis, it is recommended to consult the hepatobiliary surgery department for regular treatment in a timely manner to avoid delaying the disease.