Abstract

Carcinoma of the gallbladder is an infrequent tumor of the gastrointestinal tract. It was first described by Stoll in 1771 and it has since been recognized as a highly malignant neoplasm of older females occurring more frequently in patients with preexisting cholelithiasis. Thirty-seven cases of carcinoma of the gallbladder were reviewed and the following results were obtained. 1. The age and sex distributions were summarized in Table 1. Of the total 37 cases, the disease was most common in older females(mean age, 57 years). 2. The incidence was 4.3% of total 863 biliary tract operations during the same period. 3. Gallstones with or without stones in the common bile duct were present in 8 patients. One patient had common bile stones only. Three patients had Clonorchis sinensis. 4. The incidence of cholelithiasis accompanying carcinoma was 2.8% of total 275 cases of Cholecystectomy for Cholelithiasis during the same period. 5. The most common symptoms and signs were RUQ palpable mass, jaundice and weight loss in order. 6. The carcinoma of the gall bladder was diagnosed in only 8 cases. 7. Histologic examination of the tumors revealed adenocarcinoma in 27 of the patients, (papillary carcinoma in 10) anaplastic carcinoma in 4, squamous cell carcinoma in 4, and adenosquamous carcinoma in 2. 8. Thirty-three patients had a preexisting clinical history of recurrent RUQ pain, suggestive of cholelithiasis for a median duration of about 2 years. Twenty-five patients had a histologic evidence of chronic cholecystitis. 9. Metastatic sites were the liver, closely followed by regional Iymph node, omentum, common bile duct, ovary, stomach, ileum, and transverse colon. 10. Therefore prophylactive cholecystectomy is recommended in the young Patients suffering from cholelithiasis.