[Incidence and surgical treatment of cancer in gallbladder]

The gallbladder cancer is the most common primary cancer of the hepatobiliary system, and ranks fifth of the cancers of the gastrointestinal system. It is accidentaly found in 1-3 % of patients with gallstone disease, and in 0,5-2,4% on postmortem exam.

Show the incidence, clinical state, and suplement the diagnostic procedure of the patients with the risk factors for gallbladder cancer. Find proper surgical treatment in every stage of the disease according to Nevin-Moran system and the hystological type of the cancer.

Retrospectively we evaluated all cholecystectomies in our hospital in a three year period. We established the incidence of gallbladder cancer and we tried to discover the common characteristics of this group of patients. We analized the histological type of the cancer, and the stage of the disease in correlation with clinical presentation, results of the surgical treatment , and the survival and the quality of life.

In three years we performed 2553 cholecystectomies, and in 1,7 % of patients -43 patient we discovered the cancer of gallbladder. It is 5 times more common in females. The mean age of the patients with gallbladder cancer is 65 years (55 - 82 years). The etiology of this disease is unknown. In 5 (11,6 %) patients cancer is discovered preoperatively. In 38 (88,4 %) patients it was adenocarcinoma of the gallbladder. Other morphologic types are analplastic cancer, carcinosarcoma, and "squamous cell carcinoma". In 30 patients (69,8 %) we performed cholecystectomy, and in 8 (18,6%) patients extended cholecystectomy with its components. Radical resective procedures on liver were performed in 5 (11,6%) patients. According to the localisation in 60% of cases the cancer was located in fundus, in 30% of cases in corpus,and 10% of cases in the neck of the gallbladder. No patient with stage V survived 1 year after the procedure.

The incidence of the gallbladder cancer in our series is in the slight increase. The quality of life and the survival are inversely correlated with the depth of the invasion and the extent of the spread of the cancer. The extensive surgical procedures in advanced stage of the disease, because of the grim prognosis, does not justify the risk of the operative treatment.