Primary carcinoma of the gallbladder: study of 108 cases

From 1948 through 1970, 108 causes of primary carcinoma of the gallbladder were recorded out of a total of 17 698 cases of cancer exclusive of skin cancer (incidence, 0.6%). This review indicated that the following are the chief features of this condition: Primary gallbladder carcinoma is mainly a disease of women older than 60 years; abdominal pain occurs in most patients and jaundice in more than half, and weight loss is also common; laboratory and radiographic features are nonspecific; the diagnosis is made or strongly suspected in only one-quarter and, moreover, in many patients the disease may not be discovered until pathologic examination is conducted postoperatively. Resection was possible in 41 of the 93 patients who underwent operation but treatment was conservative because it was palliative in 20, and in 20 of the other underwent cholecystectomy the disease was not recognized at operation. Overall, the 5-year survival rate was 6.4%; for those who underwent curative resection it was 33%; and for patients without visible metastases at operation the mean survival was 3 years. Improvement in survival will come from more frequent recognition of the cancer at operation so that an operation so that an operation more adequate than cholecystectomy may be performed; that is, cholecystectomy, wedge resection of liver and resection of regional lymph nodes.