A Clinical Study on Carcinoma of the Gallbladder

Tatsuro Wakayama, Yutaka Takeuchi, Hideki Abe, Atsuto Yoshino, Makoto Mitsusada, Shuji Takahashi, Yasumasa Fukushima, Hiroyuki Hattori, Atsushi Inoue, Tadaharu Okuyama, Tadayuki Toyoda

Department of Surgery, Tokyo Metropolitan Hiroo General Hospital

Eighty-five cases of carcinoma of the gallbladder during the past 10 years were reviewed. The average age of the patients was 69 years, and the male to female ratio was 1:1.8. The most common symptom of the disease was abdominal pain. CT, angiography, and ultrasonography were the useful diagnostic measures. Among the 79 patients whose stages were clarified, there were 5 in stage II, 6 in stage III, and 68 in stage IV. Therefore most patients were in the advanced stages. As for the treatments, there were 9 patients treated by curative resection, 14 by non-curative resection, 19 by non-resection, and 43 by non-operation. Serum CEA values correlated with the progression of cancer and the histologic grade of differentiation of carcinoma. The 5-year survival rate after curative resection was 38%. The histologic type in all three patients who survived more than 4 years without recurrence was well-differentiated adenocarcinoma. The common sites of recurrence were the hepatic hilus and the liver. Regional lymph-node dissection to R2 extent is definitely necessary since recurrence at the hepatic hilus frequently occurred in the patients with insufficient lymph-node dissection.

Key words
carcinoma of the gallbladder, diagnosis and treatment of gallbladder cancer, carcinoembryonic antigen levels of gallbladder cancer

Reprint requests
Tatsuro Wakayama Department of Surgery, Tokyo Metropolitan Hiroo General Hospital
2-34-10 Ebisu, Shibuya-ku, Tokyo, 150 JAPAN

Accepted
February 13, 1991

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