Eighty-seven resected cases of gallbladder carcinoma treated in the hospital and referral hospitals were clinicopathologically reviwed with respect to the resectability and outcome. The relationship between depth of invasion and survival was determined. The 5-year survival rate was 100% for “m” and “pm” lesions. On the other hand, cases which were able to be diagnosed preoperatively were as low as 38.6% for “m” and “pm” lesions respectively. The 5-year survival rate was 55% for “ss”, 34% for “se”, or 15% in “si” lesions. Stage, Binf depth of invasion and number of lymph node metastases were the most important determinants of the resectability and outcome.
The depth of invasion and pattern of tumor spread were most useful in selecting the operative approach. Recently endoscopic ultrasonography has proven useful in determining depth of invasion preoperatively.
In concusion, it is our policy that the choice of operation, i.e., extended cholecystectomy, right hepatectomy, or pancreato-duodenectomy, is determined according to the pattern of spread, depth of invasion, and presence of lymph node metastases.