Carcinoma gall bladder : an institutional experience

This is a retrospective study of histologically proven cases of carcinoma of the gall bladder presenting to Bhaktapur Cancer Hospital and Om Hospital and Research center, Nepal, over a period of four years, from January 1999 to December 2003. The aim of this study was to review outcome of management and staging of cancer of gall bladder presenting to a specialist cancer centre. Sixty Eight patients presented over this time period; 57% presented with biliary tract symptoms and 49% had a history of chronic cholelithiasis. Twenty one patients presented with apparently resectable disease, but only those undergoing radical surgery demonstrated long term survival. Adjuvant therapies did not have any influence on outcomes. Palliative treatments, notably chemotherapy, showed some response. Besides radical surgery in truly operable cases, current treatments make little impact on this disease. Gall bladder cancer is one of the common biliary tract malignancy and demonstrates marked geographical variation. Its incidence appears to be reasonably common in Nepal. Treatment options have limited efficacy. Randomised data is urgently needed and a number of potential trials are suggested.