Primary carcinoma of the gallbladder: operative experience during a 16 year period
Oertli, D.; Herzog, U.; Tondelli, P.
European Journal of Surgery 159(8): 415-420
1993
ISSN/ISBN: 1102-4151 PMID: 8218552 Document Number: 419942
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 (TNM 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 11 disease, and this group benefit from more radical resections. For advanced tumours, palliation alone is preferable.