Results of curative operations for carcinoma of the gallbladder

Forty-two patients with carcinoma of the gallbladder under went surgical operations betweem January, 1975 and December, 1987. Among them 20 patients were curative except for three patients who died after surgery. The purpose of the this paper is to investigate relationship between the prognosis and the classification in clinical stage and relationship between the depth of the tumor and the operative modes. The survival rate was calculated by the Kaplan-Meier method. The 1-, 3-, and 5-year survival rates were 89.7%, 62.7% and 41.8%, respectively. The 5- year survival rate was 100% when limited to the mucosal layer, 75% when limited to the proper muscle layer, 0% in the subserosal layer and 26% in the serosal layer. The patients with tumor invasion which is limited to the either the mucosal layer or the proper muscle layer had relatively good prognosis. On the other hand, the prognosis of the patients with tumor invasion to either the subserosal or the serosal layer was poor. However, one patientm who had a simple cholecystectomy, died of a recurrence of carcinoma. Presently, it is considered that an extended cholecystectomy should be performed in patients with tumor invasion to the mucosal layer or the proper muscle layer. In addition, so called advanced carcinoma of the invades the hepatoduodenal ligament, and in that case a pancreatoduodenectomy should be performed for such patients.