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.