Cholecystectomy and changing mortality from gallbladder cancer.

Over the past decade, mortality from gallbladder cancer has declined sharply in England and Wales, Scotland, the United States, and Canada, but has risen by 33% in Sweden. In all these countries, gallbladder cancer mortality rates are inversely related to cholecystectomy rates in the previous year. It is suggested that changes in cholecystectomy rates produce changes in the prevalence of cholelithiasis, and consequently in gallbladder cancer incidence and mortality. It is estimated that 1 fewer death from gallbladder cancer occurs for about every 100 cholecystectomies done during the preceding year. The possibility of preventing death from gallbladder cancer in the patient with asymptomatic cholelithiasis must be balanced, however, against the risks of surgery.