Early diagnosis of primary gallbladder carcinoma.

Objective: To improve early diagnosis of primary gallbladder carcinoma (PGC) and the understanding of its pathogenesis, pathological stages and prognosis.

Methods: The data from 679 patients with PGC treated in our hospital from 1956 to 1998 were analyzed retrospectively.

Results: The incidence of PGC has been increasing in recent years, and the treatment is not satisfactory. Upon diagnosis, most patients with PGC were at advanced stage. PGC was usually found in elderly women. The ratio of man to woman was 1:3. The gallstone, closely related to PGC, was found in 60% of the patients with PGC. The diagnostic accordance rate before and after operation was low. In most patients, PGC was found unexpectedly during operation for gallstone or acute cholecystitis. Many patients with PGC missed the opportunity of diagnosis and therapy because doctor only noticed the diagnosis of gallstone. Pathological classification revealed that PGC in most patients (84.4%) were adenocarcinoma. Imaging helped to find early-stage cases and improve prognosis.

Conclusions: Understanding of pathogenesis, pathological stages and prognosis of PGC and proper use of various examinations are essential to the early diagnosis and treatment of the disease.