The patients who survive gallbladder carcinomas more than five years are usually those in whom the carcinoma was first diagnosed at microscopic examination of gallbladders removed for presumed benign disease. A group of 32 such patients (from a series of 120 cases) was studied. The prognosis was very bad (longest survival 2.5 years) in 21 of the patients where the cancer involved all the layers of the gallbladder wall. The prognosis was far better in the 11 patients in which the cancer was confined to the mucosa or submucosa. Sixty-four per cent of the patients were alive after 5 years and 44% after 10 years. Five of the 11 patients died because of recurrence. Simple cholecystectomy had been performed in all the patients except one who underwent a right hepatic lobectomy. Radical cholecystectomy including a wedge resection of liver tissue and dissection of the regional lymph nodes is recommended in all patients with inapparent gallbladder carcinomas.
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