Surgical results of operations for carcinoma of the gallbladder.

We evaluated the surgical results for carcinoma of the gallbladder. Between 1971 and 1995 we treated 258 patients, 74 of whom were treated with simple cholecystectomy, 71 with extended cholecystectomy, and 24 with more extended operations. The tumors were classified according to the stage proposed by the Japanese Society of Biliary Surgery. For m and pm carcinoma simple cholecystectomy may have an excellent result. However, it is difficult to know cancer depth exactly before or during operation, especially when combined with inflammation due to gallstones. In Stage I disease, extended cholecystectomy had an excellent result. So extended cholecystectomy is needed even in the early stage of the disease. Second operation is needed in inapparent carcinoma of the gallbladder if the tumor is more than pm or the margin is positive. More extended operations may be needed in advanced stages for curative resection. Extended hepatic lobectomy combined with pancreaticoduodenectomy should be indicated only if the patients are in good condition because of its high postoperative mortality and morbidity without a significant improvement in survival.