eng Science and Education Publishing Global Journal of Surgery 2379-8750 2017-12-19 5 1 17 19 10.12691/js-5-1-6 JS2017516 article Walid Elhaj Abdelrahim Walide45@yahoo.com 1 Kamal Elzaki Elsiddig 1 Mohamed Elhassan Akoad 2 Mohamed Abbas 2 Eltahir AG Khalil 3 Department of Surgery, Faculty of Medicine, University of Khartoum, Sudan Department of Transplantation, Lahey Clinic, Tufts University, USA Department of Clinical Pathology & Immunology, Institute of Endemic Diseases, University of Khartoum, Sudan Poor prognosis of gallbladder cancer (GBC) is due to delayed presentation. Female gender and gallstones are important risk factors. Surgical resection offers significant improvement in 5 year actuarial survival. In Sudan, proper imaging modalities and professional multi-disciplinary teams are available but, inter-disciplinary management protocols haven't been established. This paper aims to delineate the patterns of presentation, possible risk factors and the natural history of GBC to guide management practices in resource-limited settings. The records of 106 patients from two tertiary referral centres were examined. Inclusion criteria included: radiological features of gallbladder mass in addition to one of the following: liver metastasis, porta hepatis lymphadenopathy and/or ascites. The majority of patients were females (70.5%) with a mean age of 64.27±11.39 years with median duration of symptoms of 3 months. The main presenting symptoms were: loss of weight (39.2%), abdominal swelling (35.8%), obstructive jaundice (31.1%) and vomiting (17.6%). Cholelithiasis as detected by ultrasound/CT/MRI was reported in most cases (75.4%). Liver metastasis, biliary dilatation and lymphadenopathy were seen in 67.2%, 40.3% and 39% respectively. Open simple cholecystectomy was performed in a quarter of the patients (24.5%), none had re-resection after postoperative diagnosis of GBC. No significant 3 and 6 months survival benefits were observed in the simple cholecystectomy group compared to those who didn't (p=0.8 and 0.2 respectively). More than fifty per cent (51.1%) of patients received chemotherapy, with no 3 and 6 months survival benefits. The main causes of death were obstructive jaundice complicated by cholangitis and gastric outlet obstruction in 69.5% and 30.5% of patients respectively. The overall survival of CBC patients was 4.96±12.5 months. Most patients presented late, the majority had unrespectable disease, very short duration of symptoms and poor survival. Patients with advanced disease should have holistic palliative approach via a multi-discilpinary team together with systemic chemotherapy. http://pubs.sciepub.com/js/5/1/6/js-5-1-6.pdf gall bladder cancer simple cholecystectomy chemotherapy cholelithiasis