Abstract
Twelve cases of early carcinoma of the gallbladder, confined to the mucosal and muscular layer, were analyzed clinicopathologically. Eight cases of carcinoma with minimum subserosal involvement were compared with those in early stage. The early carcinomas were classified into three types according to the macroscopic findings, that is, superficial flat, superficial elevated, and protruded type. In two patients the superficial flat type carcinoma was found postoperatively by histological examination of the gallbladders removed for presumed benign disease. In two patients the superficial elevated type carcinoma was discovered intraoperatively by careful observation of the resected gallbladders. In four among eight patients of protruded type carcinoma the diagnosis was established preoperatively by ultrasonography and/or cholangiography. The depth of invasion was the mucosal layer in seven patients and the muscular layer in five. All nodes examined in six patients were negative for metastasis. The prognosis in these early carcinomas was good. On the other hand three among eight patients of carcinoma with subserosal involvement had lymph node metastases, and three patients died of recurrent carcinoma within two years. It was extremely difficult to evaluate the extent of mural invasion of gallbladder carcinoma during operation. This fact lead to the conclusion that extended cholecystectomy with regional lymph node dissection should be principally performed for carcinoma in grossly early stage.
