Primary carcinoma of the gallbladder: operative experience during a 16 year period.

OBJECTIVE

To evaluate the results of operations for primary carcinoma of the gallbladder during the 16 year period 1975-1990.

DESIGN

Retrospective study.

SETTING

University affiliated hospital in Switzerland.

SUBJECTS

55 consecutive patients with primary carcinoma of the gallbladder.

INTERVENTIONS

Resection with curative and palliative intent was done in 34 (62%) and in 10 (18%), respectively. Thirty nine (62%) had simple cholecystectomy and two (4%) radical resections; the remaining 14 (25%) had palliative operations.

RESULTS

23 Patients (42%) had early tumours (confined to the gallbladder wall, TNM stages I and II), and 32 (58%) had late tumours (TMN stages III and IV). A tumour of the gallbladder was suspected from preoperative ultrasonography in 20 of 37 examined patients (54%); 17 (31%) had occult lesions. Five patients died during the 30 day postoperative period (9%), and the overall median survival was 8.6 months. One and five year survival rates were 40% and 7%, respectively. Only four patients had long term cures after cholecystectomy alone.

CONCLUSION

There was a high incidence of locoregional recurrence among patients with stage II disease, and this group benefit from more radical resections. For advanced tumours, palliation alone is preferable.