A 60-year-old woman with a 3-month history of progressively worsening epigastric pain was referred for elective cholecystectomy after ultrasonography showed findings consistent with chronic cholecystitis (A and B). The patient reported having postprandial abdominal discomfort since 4 years of age. She also had occasional nausea and vomiting but denied jaundice, change in bowel habits,... More »

The first step in the workup of a patient with a persistent asymptomatic alkaline phosphatase (ALP) elevation is to measure gamma-glutamyltranspeptidase to determine whether the elevation is liver-related or bone-related. More »

The liver is a frequent site of metastatic colorectal disease. Over the past 20 years, improvements in systemic chemotherapy and surgical techniques have improved the survival of patients with hepatic metastases. For 4 decades, fluorouracil and leucovorin were the only drugs available to treat metastatic colorectal cancer, but several new drugs and a variety of novel regimens are now available. Further improvements in results have been seen with the delivery of chemotherapy via the hepatic... More »

The liver is a frequent site of metastatic colorectal disease. Over the past 20 years, improvements in systemic chemotherapy and surgical techniques have improved the survival of patients with hepatic metastases. For 4 decades, fluorouracil and leucovorin were the only drugs available to treat metastatic colorectal cancer, but several new drugs and a variety of novel regimens are now available. Further improvements in results have been seen with the delivery of chemotherapy via the hepatic... More »

HOUSTON, TEXAS—Preliminary data from a phase II study of oxaliplatin (Eloxatin) and capecitabine (Xeloda) in patients with unresectable gallbladder and biliary tract cancers show a response rate of 18% in More »

Hepatocellular carcinoma is one of the most common malignancies in the world, with approximately 1 million new cases recorded annually. More »

Dr. Kozuch and coauthors have written a comprehensive review of gallbladder and biliary tract carcinoma. We would like to update several issues related to this topic, with particular emphasis on new chemotherapy strategies and drug combinations for improving outcomes. More »

Cancers of the gallbladder and bile ducts are uncommon, aggressive malignancies that present both a diagnostic and therapeutic challenge. With an annual incidence of 7,200 cases in the United States, and the difficulty in diagnosing biliary tract tumors, there is a paucity of data supporting therapeutic options. This comprehensive update by Daines et al demonstrates the advances in diagnostic and staging techniques, which have led to appropriate surgical resection. Despite these advances, the... More »

Gallbladder carcinoma and carcinoma of the bile ducts are relatively rare cancers in the United States. These cancers are often diagnosed in an advanced stage due to their nonspecific symptomatology and until recently have been associated with a dismal prognosis. Recent advances in imaging and surgical techniques along with emerging options in palliative chemotherapy have improved the outlook in these cancers. While complete surgical resection remains the only hope of cure in both these cancers,... More »

During an evaluation to detect metastatic disease in a 75-year-old woman with recently diagnosed cecal cancer, a CT scan of the abdomen and pelvis revealed an incidental finding of a heavily calcified gallbladder. No metastases were found. The patient had no symptoms related to gallbladder disease. More »