Evaluation of intended radical surgery in carcinoma of the gallbladder.

The records of 44 consecutive patients with carcinoma of the gallbladder from 1968 to 1977 were reviewed. All patients were investigated with a view to resection of the tumour and this was carried out in 10 patients, all macroscopic tumour being excised in 6. The basic operation was cholecystectomy, but liver resection (4 patients), liver resection and colectomy (3 patients) and pancreaticoduodenectomy (1 patient) were also carried out. Of these 10 patients, 3 died in hospital, while of the 34 patents in whom a palliative procedure was possible, 15 died during their hospital treatment. The median survival times were 4 months and 3 months respectively. Only one patient in this series is alive and symptom-free at 36 months. It is concluded that radical surgery, of itself, does not confer any advantage to the group of patients with carcinoma of the gallbladder. Alternative strategies for diagnosis and treatment of this condition are discussed.