CARCINOMA OF THE GALLBLADDER - AN EXPERIENCE AND REVIEW OF THE LITERATURE

This paper summarizes the treatment results of 28 cases of gall-bladde r carcinoma at Toowoomba Base Hospital, Toowoomba, Queensland, Austral ia. The literature is reviewed in order to determine whether more exte nsive resection is improving the outcome of a disease generally unders tood to have a deplorable prognosis. The complete records of 28 patien ts with this malignancy were obtained from the period 1978 to 1994 and analysed retrospectively. Twenty-three patients had cholecystectomy, but only one underwent formal lymph node dissection. Overall, the 5 ye ar survival rate was 13%, and long-term survivors all had stage I or I I disease. Those with stage III or IV disease had a median survival of 46 days. Recent literature confirms that simple cholecystectomy is no t always curative for early lesions discovered incidentally and also t hat some patients with advanced disease can achieve long-term survival if treated with radical resection. Wedge resection of the liver and n odal clearance of the hepatoduodenal ligament at least has been recomm ended in patients with T-2 lesions (subserosal/perimuscular), and in s elected patients with stage III disease.