Primary carcinoma of the gall bladder: a review of our experience.

Carcinoma of the gallbladder is a rare, but deadly, cancer of the gastrointestinal tract. A retrospective review of 29 medical records of patients with primary carcinoma of the gallbladder was performed. Twenty-eight patients (96%) were age 50 or greater at diagnosis. The most common presenting symptom was abdominal pain (82.7%), followed by nausea and vomiting (44.8%). An ultrasound of the gallbladder was the most common pre-operative study (72.4%). Seventy-one percent of ultrasounds revealed only cholelithiasis. Symptomatic cholelithiasis was the most common pre-operative diagnosis (48.2%). Laparoscopic cholecystectomy was performed in 9 (31%) patients. All patients with carcinoma in situ, stage I, and stage II disease were living at last follow up. Average survival after diagnosis for stage III disease was 5.7 months, and for stage IV disease was 3.1 months. Our results and that of others lead us to believe that in any patient with a pre-operative or intra-operative suspicion of gallbladder cancer an open procedure is indicated. Furthermore, we believe that laparoscopic cholecystectomy may be inadequate and contraindicated in all but carcinoma in situ and stage I disease.