Primary carcinoma of the gallbladder
J. M. Piehler and R. W. Crichlow
The clinical records of 48 patients with primary carcinoma of the
gallbladder seen at the Dartmouth-Hitchcock Medical Center over the past 25
years were reviewed. Of the 37 patients with unresected tumors, there were
no survivors. Of the 11 patients with resected tumors, one survived five
years, two died before five years without evidence of recurrence, and the
remainder died with locally recurrent tumor. This experience reemphasizes
the inadequacy of the present surgical approach to the disease. The
tendency of carcinoma of the gallbladder to spread initially by local
invasion of the liver bed and by metastases to regional lymph nodes has
often been neglected by those treating the disease. Wedge resection of the
liver and regional lymphadenectomy in addition to cholecystectomy are
theoretically advantageous and should be striven for in the case of
resectable tumors, even if reoperation is required.
