Carcinoma of the gall-bladder remains the fifth commonest gastrointestinal malignancy. Its associations, predisposing factors and epidemiology worldwide are reviewed in this article. The clinical presentation of carcinoma of the gall-bladder is frequently late, which accounts for the poor prognosis: this is also discussed. The use of relevant imaging techniques and aggressive management offer an improved outlook. These important aspects and others, such as the use of frozen section histology, the risks of trocar seeding and inadequate resection are mentioned.

Summary. There is a large body of literature which undertakes to look at a possible association between cholecystectomy and colorectal cancer. We set out to conduct a meta-analysis to investigate this. The overall odds ratio for all studies looked at was 1.36 with 95% confidence intervals (CI) 1.07 to 1.74, significant at the 5% level (p = 0.014). The overall odds ratio fora subset of studies deemed "good studies" established by a customised ranking score was 1.66 (1.34 to 2.03), p < 0.0001. The odds ratios for cohort and necropsy studies were also ascertained and discussed. Our results would tend to support the above hypothesis. However, the limitations of this review are also discussed, and finally we suggest that if such ah association is indeed real then the increased risk is likely to be small.

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The study of molecular transport across gall-bladder epithelium may contribute to our understanding of the pathophysiology of gall-bladder disease. The aim of this study was to reconstitute and characterize single potassium ion channels in bovine gall-bladder epithelial mucosa - both apical and basolateral aspects. Standard subcellular fractionation techniques were used to form either apical or basolateral closed-membrane vesicles from the mucosal epithelium of fresh gall bladders from healthy young adult cattle. Vesicular ion channels were incorporated into voltage-clamped planar lipid bilayers under known ionic conditions and their conductances, reversal potentials, and voltages were characterized. Low-conductance voltage-insensitive apical membrane vesicle channels of at least four conductance levels were found (mean +/- SD): 12+/-4 pS, n = 10; 40+/-12 pS, n = 4; 273+/-31 pS, n = 3; and 151+/-24 pS, n = 5. Conductances of potassium ion channels in basolateral membrane vesicles were in the range 9 - 450 pS, and these channels included high-conductance calcium-activated potassium-ion channels 'K(Ca)' which were voltage- and calcium-dependent.