[Diagnosis and treatment of carcinoma of the gall bladder]

Abstract

Over the past decade considerable progress has been made in several fields relating to the diagnosis and treatment of gall bladder cancer. This literature search evaluates if these recent advances have led to improved diagnosis, treatment and survival of patients with gall bladder carcinoma. The increase in the number of cholecystectomies being carried out has resulted in more carcinomas being discovered incidentally, and at an early and treatable stage. The combination of ultrasound and MRI yields the most accurate preoperative staging. Current radiotherapy and chemotherapy in adjuvant and neoadjuvant settings have not shown any survival benefit. Surgical resection remains the only potentially curative option. For in-situ- and T1a-tumours a simple cholecystectomy can be performed resulting in favourable 10-year survival. For T1b- and T2-tumours an additional resection is indicated, resulting in 5-year survival rates of 55-90%. For T3-tumours, only those patients without metastatic disease will benefit from an additional resection.