Primary carcinoma of the gallbladder: a review of a 16-year experience at the Waterbury Hospital Health Center

Abstract

The charts of 48 cases of primary carcinoma of the gallbladder seen at the Waterbury Hospital Health Center over the past 16 years were reviewed. In 47 patients, the diagnosis was confirmed pathologically. In one patient, the diagnosis was made only on clinical and radiologic grounds. This condition is more common in females and in the elderly (mean 71.7 years). Symptoms and signs were nonspecific, and duration of symptoms was extremely variable (range: one day to 21 years). There were 16.6% patients who had an associated primary tumor elsewhere. In 89.3% of the carcinomas of the gallbladder, the histologic type was adenocarcinoma. Two thirds of the patients had associated cholelithiasis. Overall five-year survival rate was 12.5%. In more than 80% of the patients, resection was made impossible by local invasion of liver, biliary ducts, and adjacent structures. Patients were divided into three groups according to the degree of invasion of the tumor. Group A had a survival rate of 66.6% at five years. There were no survivors in Group B and Group C. The different factors in each group are compared and discussed. Chemotherapy appeared to have no beneficial effect in the management of carcinoma of the gallbladder. Only one patient survived more than 12 months when tumor invaded the liver or the nodes along the biliary ducts. The postoperative complications and causes of death are also discussed.