Carcinoma of the gallbladder

One hundred ten cases of primary carcinoma of the gallbladder occurring over a 25 year period were reviewed. Except for anemia and weight loss, the signs, symptoms, laboratory, and roentgenographic studies were of little value in the preoperative diagnosis of the disease. Most patients presented with advanced disease with extension to the liver and metastases to the common bile duct nodes. In nine patients the tumor was not clinically apparent at the time of cholecystectomy, the diagnosis being made postoperatively by the pathologist. By the end of the first postoperative year, 85 percent of the patients had died. Only two patients survived more than 5 years, for an overall 5 year survival rate of 2 percent. Usually the only survivors are patients with lesions resected early that were not apparent to the operating surgeon and without deep invasion of the gallbladder wall. The best hope for reducing the mortality from this disease lies in earlier cholecystectomy in patients with benign gallbladder disease and in extending the limits of resection when small, and presumably early, lesions are encountered.