Carcinoma of the gallbladder.

Results of a retrospective review of 20 consecutive patients with histologically proved carcinoma of the gallbladder encountered during a 15 year period confirm the historically established poor prognosis of the disease. One patient in whom the disease was discovered incidentally and early in its course is alive nine years after diagnosis. The other 19 patients died within eight months of diagnosis, regardless of the extent of the disease or method of treatment. By identifying patients who are at an increased risk, by virtue of such factors as cholelithiasis and advanced age, and scrutinizing all exposed or removed gallbladders for signs of abnormality, carcinoma of the gallbladder may be identified earlier. Then, since carcinoma of the gallbladder develops slowly and spreads along predictable pathways, radical cholecystectomy, including en bloc wedge resection of the gallbladder bed and adjacent nonvital tissue, performed upon patients with localized disease, probably offers the best chance for prolonged survival.