Outcomes of patients with gallbladder cancer presenting with acute cholecystitis

Abstract The main purpose of this study is to explore the outcomes of patients with found to have gallbladder cancer after emergency cholecystectomy for acute cholecystitis versus those found incidentally. The true incidence of primary gallbladder cancer co-existing in acute cholecystitis is not defined especially in the Western population with high incidence of gallstone disease and a low incidence of gallbladder cancer. Methods A retrospective review of all patients with gallbladder cancer managed at the Canberra Health Service between 1998 and May 2022 were identified and reviewed. Results A total of 65 patients were diagnosed with primary gallbladder cancer during the study period with a mean age of 70.4 years (SD 11.4, range 59-81.8 years) and a female preponderance (74% versus 26%) with a ratio of 2.8. Twenty (31%) patients presented with acute calculus cholecystitis and were found to have a primary gallbladder cancer. This group of patients were older and predominantly female but the difference was not statistically significant. The overall 5-year survival in the cohort was 20% (stage 1-63%, stage 2- 23%, stage 3- 16% and stage 4- 0%). There was no statistically significant difference in survival between those who presented with acute cholecystitis vs other presentations. Conclusions A third of the patients with gallbladder cancer presented with acute cholecystitis. There was no statistically significant difference in survival in those with bile spillage during cholecystectomy as well those presenting with acute cholecystitis.