Preoperative diagnosis and its effect on the treatment of carcinoma of the gallbladder.

In 19 patients with carcinoma of the gallbladder treated over a four year period, several features of percutaneous transhepatic cholangiography have been recognized which have increasingly provided an accurate diagnosis preoperatively. These features are due to intrahepatic invasion of the bile duct and by providing a diagnosis preoperatively can have a large bearing on the choice of therapy for a particular patient. The relative roles of surgical bypass and endoscopically or percutaneously placed prostheses are discussed.