Discussion
Gallbladder cancer is a rare neoplasm of the gastrointestinal tract;
however, it is the most common malignancy of the biliary tract. In 2018,
GLOBOCAN reported high age-standardized incidence rate(ASIR) of gall
bladder carcinoma in South Asia. Cholelithiasis is the most common risk
factor for developing gallbladder
cancer.(7) There is an
approximately 10-fold higher risk of developing gallbladder cancer in
patients with gallstones larger than 3
cm.(8)
As a high proportion of tumors is already advanced at the time of
presentation, the prognosis of gall bladder carcinoma is generally
extremely poor. This is reflected by the 5-year survival for all stages
of gallbladder cancer which is about 5%.(9,10) Resection remains the
only chance for a cure because chemotherapy and radiotherapy are
ineffective as primary treatments. Various surgical options for
treatment have evolved over the last 10 years such as procedures ranging
from a simple cholecystectomy to a radical or extended cholecystectomy.
They may include liver resections, from segmentectomies to right
hepatectomies and trisectionectomy.
Pancreatic pseudocysts form usually after 4 weeks of initial insult and
are commonly associated with acute pancreatitis or pancreatic
trauma.(11) They may also occur in approximately 20%-40% of patients
with chronic pancreatitis.(12)
Pancreatic pseudocyst may resolve spontaneously and thus can be managed
conservatively by watchful monitoring.(13) Indications for decompression
of pseudocyst are abdominal pain, nausea and vomiting, superimposed
infection, and gastric outlet or biliary tract obstruction.(14)
Association of gallbladder carcinoma with pancreatic pseudocyst is rare.
Only a few case studies have been reported of this association.