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Primary carcinoma of the gallbladder: operative experience during a 16 year period
D Oertli1, U Herzog, P Tondelli
1Department of Surgery, St. Claraspital, Basel, Switzerland.
Objective:
To evaluate the results of operations for primary carcinoma of the gallbladder during the 16 year period 1975-1990.
Design:
Retrospective study.
Setting:
University affiliated hospital in Switzerland.
Subjects:
55 consecutive patients with primary carcinoma of the gallbladder.
Interventions:
Resection with curative and palliative intent was done in 34 (62%) and in 10 (18%), respectively. Thirty nine (62%) had simple cholecystectomy and two (4%) radical resections; the remaining 14 (25%) had palliative operations.
Results:
23 Patients (42%) had early tumours (confined to the gallbladder wall, TNM stages I and II), and 32 (58%) had late tumours (TMN stages III and IV). A tumour of the gallbladder was suspected from preoperative ultrasonography in 20 of 37 examined patients (54%); 17 (31%) had occult lesions. Five patients died during the 30 day postoperative period (9%), and the overall median survival was 8.6 months. One and five year survival rates were 40% and 7%, respectively. Only four patients had long term cures after cholecystectomy alone.
Conclusion:
There was a high incidence of locoregional recurrence among patients with stage II disease, and this group benefit from more radical resections. For advanced tumours, palliation alone is preferable.