NATURAL HISTORY OF CARCINOMA OF THE GALLBLADDER AND ITS INFLUENCES ON MANAGEMENT.

There were 45 patients (8.8%) of carcinoma of the gall bladder among 506 patients of gall bladder disease admitted during January 1993 to June 1995. Female to male ratio was 4:1 and average age at detection was 52 years. Pain right hypochondrium and jaundice were prominent clinical features. Ultrasonography accurately diagnosed 33 (73.3%) cases while computed tomography was correct in 15/22 (75%) of cases. Cholelithiasis was present in 37 (80%) patients. Sixteen patients were not offered surgery due to either widespread disease or due to poor general health. Cholecystectomy with wedge or segmental resection of liver and lymphadenectomy was performed in 18 out of 29 patients. In 6 patients segmental resection of the contiguous involved organ was performed. Perioperative mortality was 8 per cent. Two patients were alive for more than 24 months, 7 for more than 12 months and 11 were being followed-up for 1 to 12 months. All patients not offered surgery died within 4 months.