Clinicopathological Studies on the Patients with Carcinoma of the Gallbladder in Shirone Area of Niigata -A Study in the High Risk Zone

Yoshinobu Sato, Minoru Fukuda, Masaki Hirota, Yoshihiro Baba¹⁾, Akio Igarashi¹⁾, Minoru Abe¹⁾, Keisuke Yoshida²⁾

Department of Srugery and Medicine¹⁾, Shirone Kensei Hospital
First Department of Surgery, Niigata, University²⁾

Diagnosis and operative results in 33 patients with carcinoma of the gallbladder (GBC) were reviewed in order to improve the prognosis of this disease, which is difficult to cure. The high incidence of gallstone positive GBC among patients with cholelithiasis (5.5%) showed that the Shrone district is a zone of very high risk for GBC. The rate of preoperative correct diagnosis improved significantly after the interoduction of endoscopic ultrasonography (21% to 83% in resectable cases). However, intraoperative diagnosis by macro-scopical observation of the specimen was still important for detecting superficial type early carciomas. Four out of 5 patients who were checked through the health examination by ultrasonography were treated succussfully. Therefore, mass screening by ultrasonography was considereduseful. GBC was resected in 25 patients (76%). However, curative resection was performed in only 18 patients (54.5%). Cumulative 3- and 5-year suvival rates for the resected cases excluding operative death (one case) and death by coexisting gastric cancer (2 cases) were 53.7% and 43.0%, respectively. The outcome in stage I was excellent including those patients who underwent simple cholecystectomy only. However the rate of recurrence was high in stage II or more advanced stages. A more radical procedure including excision of the extrahepatic bile duct and systemic dissection of the hepato-duodenal ligament must be used in patient with advanced GBC.

Key words
carcinoma of the gallbladder

Reprint requests
Yoshinobu Sato First Department of Surgery, Niigata University Asahi-machidori, Niigata, 951 JAPAN

Accepted
December 13, 1989

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