A Clinical and Pathological Study on Early Primary Carcinoma of the Gallbladder

Abstract

Many authors report that the onset of carcinoma of the gallbladder is insidious and often reaches a advanced stage before it becomes clinically manifest as a malignant condition. But, the fact is well known that cholelithiasis often precedes and may be an etiological factor.
So, it is considered worth while for early diagnosis and treatment to clarify the clinical and pathological features of relatively early primaly carcinoma of the gallbladder.
Seventeen cases of carcinoma of the gallbladder were analyzed in detail for clinical and laboratory data and pathological results.
They were divided into the early carcinoma which had a better prognosis surviving for over three years after cholecystectomy, and the progressed carcinoma which had a worse prognosis dying within one year after the admission to hospital.
The early carcinoma was almost combined with gallstone and showed clinical signs and symptoms as chronic cholecystitis or cholelithiasis with a long clinical course for over two years, while the progressed carcinoma was combined with symptomless gallstone or without gallstone and showed clinical signes and symptoms as a malignant condition with a short clinical course for several months.
Among many clinical investigations, cholecystographic diagnosis was the most valuable for the early carcinoma.
From gross appearance of the mucous membrane surface, the early carcinoma was divided into the flatt, protuberant and hollowed type.
It could be considered that early primary carcinoma of the gallbladder to expect a relief by surgery show microscopically a localized infiltrtion to the mucosa and musculature without penetration through the muscular layer and no metastasis to lymph nodes and other organs.