[Primary cancers of the gallbladder. Apropos of a homogeneous series of 75 cases]

Abstract

Seventy-five cases of primary carcinoma of the gallbladder are reviewed retrospectively under observation of a fifteen year period, representing 2.4 per cent of the number of biliary tract surgery performed during the same period. The majority of the patients presented with advanced disease with extension and metastases to the liver (56%) and to the adjacent organs (53.3%) and to the lymph nodes along the common bile duct (21.3%). Eleven patients had localized disease at the time of the operation; they were treated with cholecystectomy. Eight patients had clinically inapparent carcinoma at the time of the cholecystectomy; the diagnosis being established post-operatively by histologic examination of the excised gallbladder. There were no five years survivors in this second group of patients, but five of them are one year survival (62.5%) and one is still alive three years and six months after surgery. The remaining patients with inapparent carcinoma died within three years of the time of the operation. The present report emphasize the poor prognosis associated with carcinoma of the gallbladder and the presence of gallstones. Carcinoma of the gallbladder in our experience has proved curable only when accidentally discovered at cholecystectomy for presumed benign biliary tract disease. This fact plus the frequent and serious non neoplastic complications of neglected gallstones are strong indications for early elective cholecystectomy and extended resection may improve the survival rate.