How long can you live with vomiting blood from gallbladder cancer

How many years can a patient live after successful surgery for gallbladder cancer? Surgery is the preferred treatment for gallbladder cancer patients. Therefore, after the patient is diagnosed, many people want to know how long they can live after surgery for gallbladder cancer. There is no clear answer to this question. Experts say that the prognosis is poor. How long a patient can live after surgery is mainly related to the following:

Surgical treatment of gallbladder cancer The treatment of gallbladder cancer is mainly based on surgery, but due to the insidious onset, no specific symptoms, and difficulty in early diagnosis, few patients can be surgically removed, with domestic literature reporting 50%. Even fewer patients can undergo radical surgery, only 20.2%. Even if the lesion has been removed, the average survival time after surgery is only 8.4 months, and nearly 905 patients die within 1 year after surgery. The 5-year survival rate is less than 5%, with some reports of 14.5%. In recent years, surgical resection of the lesion plus intraoperative radionuclide irradiation has been carried out abroad to treat advanced patients, which may improve their prognosis and quality of life. Surgery for gallbladder cancer can also be divided into palliative surgery, radical surgery, and extended radical surgery. Palliative surgery refers to the use of local resection of the gallbladder mass or various drainage surgeries to improve the patient's symptoms when the tumor is no longer curable. Radical surgery should have different meanings depending on the early or late stage of the disease. For carcinoma in situ or early cancer limited to the mucosa, simple cholecystectomy can be considered a radical cure. For patients who have invaded the muscle layer or the entire gallbladder wall, it is necessary to remove 2 to 3 cm of liver tissue and the cystic duct and the lymph nodes around the common hepatic duct to be considered a radical cure. For advanced patients whose liver has been invaded and whose surrounding lymph nodes have metastasized, extended radical surgery is the only option. Extended radical surgery refers to the removal and reconstruction of the right liver lobe, pancreatic head, duodenum, and blood vessels when there is metastasis to the regional lymph nodes or adjacent organs.

Occult gallbladder cancer refers to a condition that has not been diagnosed before or during surgery, but is diagnosed as gallbladder cancer by pathological examination after cholecystectomy for a "benign" disease. Since occult gallbladder cancer is diagnosed after surgery, the question is whether radical surgery is needed again. For patients whose postoperative pathology confirms that the cancer has only invaded the mucosal layer or the muscular layer, a complete cholecystectomy alone is sufficient to achieve the goal of radical cure, and a second radical surgery is not necessary. Since the location of the cancer in the gallbladder neck, especially the cystic duct, is close to the gallbladder triangle, lymph node metastasis is prone to occur earlier. Therefore, no matter which layer of the gallbladder wall is invaded, lymph node dissection around the hepatoduodenal ligament should be performed again. A second radical surgery should also be performed for occult gallbladder cancer that has infiltrated beyond the muscular layer, has a positive resection margin, and has a positive gallbladder triangle lymph node biopsy.

For advanced cases that cannot be cured, the principle of surgery is to relieve pain and improve the quality of life. The prominent problem of advanced gallbladder cancer is that the obstructive jaundice caused by cancer invasion of the bile duct should be considered for internal drainage as much as possible. The methods of internal drainage include bile duct jejunostomy, bridging internal drainage, etc. For cases with extremely poor systemic conditions, external drainage can also be performed. At present, memory alloy stents have been successfully used in biliary surgery. For patients with bile duct obstruction, stents are placed during surgery to support the bile duct, which can drain the bile.

For patients after surgery, radiotherapy and/or chemotherapy as well as traditional Chinese medicine should be used as appropriate to prolong survival. For patients with liver metastases that have been resected or cannot be resected, hepatic artery and/or portal vein chemoembolization can be used for treatment, but the number of cases is small and needs further verification.