Gallbladder carcinoid

　　Gallbladder carcinoid originates from Kultchitsky cells in the neuroendocrine tissue and is a relatively rare endocrine tumor. It mostly occurs at the bottom of the gallbladder, with the carcinoid tissue appearing pale yellow, turning brown after fixation with formalin. It is firm in texture, with a homogeneous appearance in cross-section. Under the microscope, the tumor cells are small and polygonal. The nuclei are of moderate size, the cytoplasm is slightly alkaline, and there are silver-containing granules and lipid vacuoles. The granules contain serotonin.

　　In addition to general symptoms, gallbladder carcinoid can also cause other diseases. Some patients with this condition may develop extrahepatic biliary tract obstruction due to a large mass or proximity to the common bile duct. Therefore, once detected, active treatment is required, and preventive measures should also be taken in daily life.

　　Gallbladder carcinoid lacks specific clinical manifestations. Most patients have a history of acute or chronic cholecystitis, presenting with discomfort in the upper right abdomen, feeling of stuffiness, accompanied by aversion to oil and loss of appetite. Some patients may develop extrahepatic biliary tract obstruction due to a large mass or proximity to the common bile duct, leading to obstructive jaundice or cholangitis, with a low incidence of carcinoid syndrome, accounting for about 7%.

　　Currently, there is no good prognostic indicator for gallbladder carcinoma. The degree of differentiation of tumor cells seems to have little to do with the prognosis. According to literature reports, if the tumor is limited to the gallbladder wall and there is no distant metastasis, the prognosis after gallbladder resection is good. Once the tumor invades the liver bed or there is local lymph node metastasis, even if extensive resection is performed, it cannot improve the prognosis. Radiotherapy and chemotherapy seem to be unable to change the prognosis. In addition, the prognosis of males is better than that of females.

　　If gallbladder carcinoma patients have biliary obstruction, the level of bilirubin in the blood will increase. About 60% of patients with this disease can be found to have hyperechoic space-occupying lesions in the gallbladder during B-ultrasound examination, with a diameter generally less than 2cm.

　　In addition to general treatment, patients with gallbladder carcinoma should also pay attention to adjusting their diet.

　　1. To maintain smooth defecation, use jellyfish, bitter melon, sweet potatoes, etc.

　　2. To prevent infection and fever, use mung beans, Brassica rapa, toon, taro, ear fungus, bitter melon, lily, crucian carp, Malan head, loach, etc.

　　3. To protect the function of the digestive system, use beets, myrica, yam, Job's tears, radish, etc.

　　4. Eating more foods beneficial for biliary drainage and anti-cancer, such as foxtail millet, Job's tears, hedgehog mushrooms, dregs of tofu, chrysanthemum, sea cucumber, figs, sesame seeds, sea buckthorn, etc.

　　The treatment methods for gallbladder carcinoma include surgical treatment and chemotherapy, as follows:

　　1. Surgical Treatment

　　Surgical operation is the main means of treatment. The surgical method varies according to the range of tumor infiltration. If the tumor is limited to the gallbladder mucosa or muscular layer, a simple gallbladder resection can be performed. If the tumor invades the serosal muscular layer or the liver bed, a gallbladder resection, partial resection of the liver bed, and dissection of the porta hepatis lymph nodes should be performed. If the liver is locally infiltrated extensively but there are no signs of distant metastasis, liver lobe resection can also be performed on the basis of the above resection.

　　2. Chemotherapy (Radiotherapy)

　　The effects of radiotherapy and chemotherapy are poor. Literature has reported a case of a patient with gallbladder carcinoma who received combined radiotherapy and chemotherapy after surgery, but it was difficult to control the growth of the tumor. After that, chemotherapy was used alone, but it only had a suppressive effect on the tumor in the short term. The tumor recurred locally soon.