Carcinoma of the gall bladder is a lethal disease with almost a 100 per cent mortality.
The problem of carcinoma of the gall bladder still remains to be solved. The early signs and symptoms of this tumor cannot be seperated from nonmalignant diease of the biliary tree, with which, almost always, it is associated. The late symptoms and signs usually are obvious, but by then, the chance for even palliative treatment has been lost.
Twenty-three cases of carcinoma of the gall bladder, treated in Seoul National University Hospital between January 1961 to August 1971, have been reviewed.
1. The incidence was 2.40% of 950 biliary tract operations for 10 years and the cases associated with stones were 17 (72%). Fifteen of our patients were male(65%).
2. There was no specific symptoms different from gall stone. The frequent symptoms were right upper quardrant colic radiating to back, tenderness of upper abdomen, nausea and vomiting, weight loss, chill and fever and palpable gall bladder. The duration of these symptoms were , between 4 months to 3 years.
3. Six patients were diagnosed clinically suspecious as gall bladder carcinoma, three by percutaneous transhepatic cholangiography, thirteen patients were confirmed on operation and the other four patients were confirmed by histology after operation.
4. The metastatic sites were liver, regional lymph, nodes, omentum, bile duct, pancreas and peritoneum in order. All of the histologic findings were adenocarcinoma except one angiosarcoma and two adenoacanthomas.
5. Eleven patients had undergone biopsy only, but the other eleven patients had undergone palliative procedures; two cholecystomy, two T-tube choledochostomy and seven cholecystectomy. The last one patient had undergone radical cholecystectomy combined with right hepatic lobectomy.
6. Only one patient who had undergone cholecystectomy and right hepatic lobectomy, survived more than five years but the other patients died within one year.
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