Gallbladder Carcinoma First Diagnosed at Microscopic Examination of Gallbladders Removed for Presumed Benign Disease

Abstract

The patients who survive gallbladder carcinomas more than five years are usually those in whom the carcinoma was first diagnosed at microscopic examination of gallbladders removed for presumed benign disease. A group of 32 such patients (from a series of 120 cases) was studied. The prognosis was very bad (longest survival 2.5 years) in 21 of the patients where the cancer involved all the layers of the gallbladder wall. The prognosis was far better in the 11 patients in which the cancer was confined to the mucosa or submucosa. Sixty-four per cent of the patients were alive after 5 years and 44% after 10 years. Five of the 11 patients died because of recurrence. Simple cholecystectomy had been performed in all the patients except one who underwent a right hepatic lobectomy. Radical cholecystectomy including a wedge resection of liver tissue and dissection of the regional lymph nodes is recommended in all patients with inapparent gallbladder carcinomas.

Significance of Subserosal Lesions and Results of Extended Cholecystectomy in the Treatment of Primary Carcinoma of the Gallbladder

“…Most long-term survivors have undergone cholecystectomy for cholelithiasis, with gallbladder carcinoma detected incidentally in the surgi cal specimen by the pathologist [1], Many authors, how ever, believe that treatment of carcinoma of the gallblad der should include cholecystectomy, resection of adjacent hepatic substance, and meticulous dissection of known areas of lymphatic drainage. This procedure has been termed extended (or radical) cholecystectomy [2][3][4][5], Based on an analysis of data from 15 and 10 patients treated by extended cholecystectomy, Glenn et al [6] and Evander et al [7] concluded that survival was not en hanced significantly by this procedure. However, other authors [1, 8.…”

Fine Needle Aspiration Cytodiagnosis of Primary Squamous Cell Carcinoma of the Gallbladder

“…Until the use of abdominal imaging techniques, such lesions were often an unsuspected finding, and the diagnosis was rarely established. 7,22,25 Based on a few recent studies using imaging modalities, it seems that lesions in the gallbladder can now be diagnosed at an early, curable stage. 9,10,23,25 Prognostically this could be quite critical as staging of the tumor is a factor in outcome.…”

Dye-Staining Stereomicroscopic Examinations for Fine Mucosal Structures of the Gallbladder

“…Although the preoperative diagnosis of a gallbladder carcinoma has been improved greatly by various imaging techniques, it is not rarely diagnosed intraoperatively or postoperatively [1, 2, 3]. Under these circumstances, especially in patients with advanced gallbladder carcinomas, reoperation is occasionally needed.…”