SEARCH · PubMed Health

Results for “Gallbladder”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,531 records · Page 85Linked to original sources

PubMedDate not supplied

Duplication of the gallbladder with advanced adenocarcinoma: diagnostic value of MRI and angiography.

We present a very rare case of duplicated gallbladder in which the accessory gallbladder was involved by advanced adenocarcinoma with stones. In this case, MRI was the most useful modality in revealing the cystic formation of the accessory gallbladder with packed stones beside the main gallbladder. Additionally, celiac angiography demonstrated the unusual form of the intrahepatic artery which enveloped the cystic tumor, that might be a diagnostic characteristic of accessory gallbladder.

Adenocarcinoma↗

PubMed1995

[Contractile effect of erythromycin on the gallbladder].

The contractile effect of erythromycin on gallbladder has not been fully understood. This effect was investigated in the isolated gallbladder of golden hamster gallstone model and in human by ultrasonography. Erythromycicn induced concentration-dependent contraction of gallbladder in 28 hamsters with normal diet and in 13 with gallstone diet. In those two groups the maximal contractile effect and the half maximal effective concentration were similar (P > 0.05). In clinical study, the fasting volume and residual volume were significantly diminished in 23 volunteers and 15 with cholecystolithiasis and the ejection fraction and the constant emptying rate increased (P < 0.05). Erythromycin also modulated the hypomotility of gallbladder in gallstone patients, hence could be used in gallbladder hypomotility cases.

Animals↗

PubMedDate not supplied

Surgery for carcinoma of the gallbladder.

BACKGROUND/AIMS: Carcinoma of the gallbladder is one of the gastrointestinal malignancies with an extraordinarily poor prognosis. The 5-year survival rate amounts to less than 5 per cent in most series. Our aim was to analyze the experience of a single center with surgery for gallbladder carcinoma with special reference to liver wedge resection. MATERIALS AND METHODS: A retrospective analysis examined all patients of the Clinic of Surgery of the Humboldt University Medical School (Charité) with diagnosed gallbladder carcinoma operated on between January 1981 and August 1993. The analysis was based on patient documentation. Cumulative survival rates were calculated according to the method of Kaplan/Meier. Statistical significances were calculated using logrank and Wilcoxon's tests. RESULTS: Eighty one patients (61 female, 20 male) were included in the study. The preoperative diagnoses were confirmed in 33 patients (40.7%). The stage distribution according to the TNM-system revealed 6, 10, 12, and 53 patients at the stages I-IV, respectively. The curative resection rate was 22.2%. Stage-dependent surgical procedures resulted in cumulative survival rates of 33.3% for stages I and II, 8.3% for stage III and 1.9% for stage IV. The overall prognosis was significantly determined by metastatic spread to the lymph nodes. CONCLUSIONS: Diagnostic efforts should focus on detecting the low stages I and II of gallbladder carcinoma. Our results suggest that aggressive surgical management with second intervention and wedge resection or more extended liver resection is the method of choice for stage T1b or more advanced stages of gallbladder carcinoma.

Adenocarcinoma↗

PubMed1993

[Drug effects on gallbladder motility (based on dynamic ultrasonic data)].

Ultrasound registration of changes in gallbladder volume by the method of cylinder sum allows reliable means of studying gallbladder contractility in response to pharmacological load. Cerucal increased this activity in chronics with gastroduodenitis and diabetes mellitus, pentagastrin reduced the gallbladder volume. In duodenal ulcer patients a single dose of dalargin dilated the gallbladder for a short time, while in course treatment did not influence it. Gastrocepin inhibited motor activity of gallbladder as well as corinfar.

Chronic Disease↗

PubMed1997

[Nonadrenergic noncholinergic regulation of gallstone containing and gallstone free human gallbladders].

UNLABELLED: This study is to determine the role of nitric oxide (NO), as primary neurotransmitter of the non-adrenergic noncholinergic (NANC) innervation, of stone-diseased and stone-free human gallbladders. Human gallbladder muscle strips were mounted in modified Krebs-Henseleit-solution with atropine (1 microM), guanethidine sulf. (5 microM) and aerated with Carbogen. Electrical field stimulation (EFS, 70V, 0.5 ms, 100 pulses) was used at frequencies of 1, 3, 10 Hz to activate NANC nerves, L-omega-nitro-L-arginine (L-NNA, 100 microM), L-arginine (L-ARG, 120 microM) was used to manipulate the NO-synthase. Gallbladder slices of 3 microns were stained by means of APAAP-method (alkaline phosphatase anti alkaline phosphatase) for histological examination. In the control group (basal tone = 8.94 +/- 1.17 mN) EFS caused a frequency dependent reduction of basal tone (1 Hz = 5.73 +/- 0.81 mN; 3 Hz = 5.18 +/- 0.65 mN; 10 Hz = 4.63 +/- 0.49 mN). Incubation with L-NNA increased the tone (7.63 +/- 0.76 mN). Contractor group (basal tone = 7.79 +/- 0.93 mN) reacted like the control group but frequency independent and additionally with spontaneous phasic contractions. In the non-contractor group (basal tone 4.13 +/- 0.65 mN) EFS only decreased the frequency of spontaneous phasic contractions. L-NNA caused an increase in tone (5.97 +/- 0.84 mN) and frequency, L-Arginine significantly reversed this effect. HISTOLOGY: Contractor group showed wrinkled mucosal membrane and mild grade of inflammation. Shallow mucosa, necrosis and high grade of inflammation were found in the non-contractor group. CONCLUSIONS: 1. In vitro, NANC-relaxation of human gallbladder is NO dependent. 2. Motility of stone-diseased gallbladders is modulated by NO and seems to depend on the degree of scarrification.

Adrenergic Fibers↗

PubMedDate not supplied

Ras gene point mutations in gallbladder lesions associated with anomalous connection of pancreatobiliary ducts.

BACKGROUND/AIMS: The present study was undertaken to investigate possible changes in the K-ras oncogene in patients with gallbladder lesions (carcinoma, adenoma or hyperplasia) in relation to the presence or absence of an anomalous connection of pancreatobiliary ducts (ACPBD). METHODOLOGY: Gallbladder specimens were obtained from 44 patients with lesions that were either with or without ACPBD, and DNA samples were analyzed using PCR-SSCP. Point mutations in codons 12, 13 and 61 were analyzed by direct sequencing methods with oligonucleotide primers. RESULTS: The K-ras codon 12 was detected in 83.3% (5/6) of carcinomas the one adenoma tested and in 35.7% (5/14) of hyperplastic lesions with ACPBD, as opposed to only 36.4% (4/11) of carcinomas without ACPBD. The one case of gallbladder adenoma and 11 cases of normal gallbladder without ACPBD studied demonstrated no point mutations in the K-ras oncogene. CONCLUSIONS: Alteration of the K-ras oncogene appears to be involved in the early stages of gallbladder carcinogenesis when in association with ACPBD. The results further suggest that hyperplasia in cases with ACPBD may be a significant pre-cancerous lesion.

Adenocarcinoma↗

PubMedDate not supplied

[The ultrasonic diagnosis of the interdigestive phase motility of the gallbladder in healthy subjects and duodenal peptic ulcer patients].

The contractile function and tone of the gallbladder were studied under basal conditions with regard to phases of interdigestive motility of duodenum in 100 patients with duodenal ulcer and 20 healthy controls. It has been ascertained that in healthy subjects and patients with ulcer disease, the gallbladder tends to function in a manner consistent with phases of interdigestive motility of duodenum. Patients with ulcer disease show hypermotoric dyskinesia of the gallbladder and biliary tract evidenced by diminution of its capacity as well as by hypertonicity. It is necessary that ultrasonics to study the gallbladder be used with regard to phases of the interdigestive motility of duodenum, the latter consideration being important in studying the gallbladder's motor function. The most significant results are obtainable during the second phase of duodenal irregular contractions (2 phases).

Adult↗

PubMedDate not supplied

The potential site of disordered gallbladder contractility during the early stage of cholesterol gallstone formation.

BACKGROUND/AIMS: Feeding a high cholesterol diet to dogs causes a reduction in gallbladder smooth muscle contractility with a consequent stasis. Gallbladder stasis is an important link between the hepatic secretion of cholesterol saturated bile and the formation of cholesterol gallstones. METHODOLOGY: In this study we tried to localize the probable site of gallbladder smooth muscle dysfunction in a well established animal model of cholesterol gallstone disease. Adult male dogs were fed either a high or low cholesterol diet (control group). Strips of gallbladder smooth muscle for tension development were stimulated with two groups of agonists and dose response curves were plotted for all agonists used. RESULTS: The forces developed in response to the first group of agonists, the cell membrane-active agonists, e.g. acetylcholine, cholecystokinin, and potassium chloride were decreased in high cholesterol fed dogs with an increased cholesterol saturation of bile when compared to the control group. On the other hand, the contractile response showed non-significant differences between the test and the control group on using the second group of agonists that bypass the intact sarcolemmal membrane and stimulate directly either the contractile mechanism, e.g. barium, or the intracellular signal transduction pathways e.g. aluminum fluoride. CONCLUSION: We conclude that the smooth muscle defect responsible for disordered gallbladder contractility in high cholesterol fed dogs most probably involves the sarcolemmal membrane.

Acetylcholine↗

PubMed1982

Perforation of the gallbladder due to blunt abdominal trauma.

Gallbladder perforation due to blunt trauma is an uncommon finding. We report our experience with six patients. The factors predisposing to perforation include a distended gallbladder because of either fasting or alcohol ingestion in normal patients, and obstruction of the cystic in patients with cholelithiasis. The diagnosis of gallbladder perforation after blunt injury may be suspected in patients with signs of an acute abdomen and hypotension that is not explained by blood loss. Peritoneal lavage that contains bile suggests the tentative diagnosis of trauma to the biliary tract or gallbladder, as well as to the liver or upper bowel. A cholecystectomy is the preferred treatment when gallbladder perforation occurs in the traumatized patient.

Abdominal Injuries↗

PubMed1988

Effects of female sex hormones and pregnancy on gallbladder prostaglandin synthesis.

To investigate whether female sex hormones and pregnancy induce increased gallbladder synthesis of prostaglandin I2 (PGI2) and prostaglandin E (PGE), we used an in vitro incubation chamber to quantitate the effects of progesterone, estrogen, pregnancy, and pregnancy plus a 2%-cholesterol diet on mucosal and serosal PGI2 and PGE production by the rabbit gallbladder. Neither the female sex hormones nor pregnancy alone caused a significant increase in PGI2 or PGE synthesis. The gallbladders of cholesterol-fed, pregnant rabbits demonstrated significant increases only in serosal synthesis of PGI2. This increased production was equivalent to that noted for gallbladders from nonpregnant rabbits fed a high-cholesterol diet. There were no increases in mucosal synthesis of PGE or of PGI2. Thus, neither elevated levels of progesterone or estrogen nor pregnancy is directly responsible for the increased PGI2 activity in the female gallbladder; conversely, this effect seems to be mediated by the increased biliary concentrations of cholesterol.

Animals↗

PubMed1989

Gallbladder response to enteral lipids in injured patients.

Severely injured patients are at risk for complications of gallbladder stasis in a spectrum from sludge formation and cystic duct occlusion by inspissation and, subsequently, acalculous cholecystitis. In a double-blind randomized trial, the effect of enteral lipids on the ability of the gallbladder to clear itself was tested. The gallbladder was assessed by ultrasonography for acute contractions, sludge and dilatation on days 1, 3, and 7 after injury. There were no significant differences between patients who received enteral lipids and controls. Both groups showed modest enlargement of the gallbladder and failure of contraction. In a population at risk for biliary stasis following severe trauma, standard enteral lipids did not elicit, acutely or chronically, an appropriate reflexive evacuation of the gallbladder.

Adult↗

PubMed1993

Gallbladder cancer discovered during laparoscopic surgery. Potential for iatrogenic tumor dissemination.

OBJECTIVE: To examine the results of treatment of laparoscopically discovered gallbladder cancer. DESIGN: Retrospective review of clinical data for the 10 patients with laparoscopically discovered gallbladder cancer who were referred to our institution for definitive surgical therapy. SETTING: An oncologic referral center. PATIENTS: All patients in the 24-month period from November 1990 to November 1992 with this entity who were referred for surgical therapy. INTERVENTION: Exploratory laparotomy was performed on all patients. Resection with curative intent was performed when possible. MAIN OUTCOME MEASURES: Resectability and outcome of cancer treatment. RESULTS: In three patients, a subsequent radical resection was performed and as a result, two patients are currently free of disease. Intraperitoneal spread, not present at the original laparoscopy and associated with violation of tumor at laparoscopy, precluded potentially curative resection for four patients. In two of these patients, there was obvious tumor growth within the laparoscopy tracts. CONCLUSIONS: Tumor dissemination is a real hazard of laparoscopic violation of gallbladder integrity in the presence of gallbladder cancer. Modification of management based on awareness of such a hazard is needed to improve resectability and outcome of future cases of laparoscopically discovered gallbladder cancer.

Aged↗

PubMed2005

Effect of estrogen therapy on gallbladder disease.

CONTEXT: Estrogen therapy is thought to promote gallstone formation and cholecystitis but most data derive from observational studies rather than randomized trials. OBJECTIVE: To determine the effect of estrogen therapy in healthy postmenopausal women on gallbladder disease outcomes. DESIGN, SETTING, AND PARTICIPANTS: Two randomized, double-blind, placebo-controlled trials conducted at 40 US clinical centers. The volunteer sample was 22,579 community-dwelling women aged 50 to 79 years without prior cholecystectomy. INTERVENTION: Women with hysterectomy were randomized to 0.625 mg/d of conjugated equine estrogens (CEE) or placebo (n = 8376). Women without hysterectomy were randomized to estrogen plus progestin (E + P), given as CEE plus 2.5 mg/d of medroxyprogesterone acetate (n = 14,203). MAIN OUTCOME MEASURES: Participants reported hospitalizations for gallbladder diseases and gallbladder-related procedures, with events ascertained through medical record review. Cox proportional hazards regression was used to assess hazard ratios (HRs) and 95% confidence intervals (CIs) using intention-to-treat and time-to-event methods. RESULTS: The CEE and the E + P groups were similar to their respective placebo groups at baseline. The mean follow-up times were 7.1 years and 5.6 years for the CEE and the E + P trials, respectively. The annual incidence rate for any gallbladder event was 78 events per 10,000 person-years for the CEE group (vs 47/10,000 person-years for placebo) and 55 per 10,000 person-years for E + P (vs 35/10,000 person-years for placebo). Both trials showed greater risk of any gallbladder disease or surgery with estrogen (CEE: HR, 1.67; 95% CI, 1.35-2.06; E + P: HR, 1.59; 95% CI, 1.28-1.97). Both trials indicated a higher risk for cholecystitis (CEE: HR, 1.80; 95% CI, 1.42-2.28; E + P: HR, 1.54; 95% CI 1.22-1.94); and for cholelithiasis (CEE: HR, 1.86; 95% CI, 1.48-2.35; E + P: HR, 1.68; 95% CI, 1.34-2.11) for estrogen users. Also, women undergoing estrogen therapy were more likely to receive cholecystectomy (CEE: HR, 1.93; 95% CI, 1.52-2.44; E + P: HR, 1.67; 95% CI, 1.32-2.11), but not other biliary tract surgery (CEE: HR, 1.18; 95% CI, 0.68-2.04; E + P: HR, 1.49; 95% CI, 0.78-2.84). CONCLUSIONS: These data suggest an increase in risk of biliary tract disease among postmenopausal women using estrogen therapy. The morbidity and cost associated with these outcomes may need to be considered in decisions regarding the use of estrogen therapy.

Aged↗

PubMed1997

Reliability of frozen section diagnosis of gallbladder tumor for detecting carcinoma and depth of its invasion.

BACKGROUND: An accurate frozen section diagnosis is important when deciding the surgical strategy against a gallbladder tumor intraoperatively. Little has been reported on the accuracy of frozen section diagnosis of the gallbladder. PATIENTS AND METHODS: In a total of 86 consecutive patients with gallbladder tumor, the accuracy of the frozen section diagnosis was examined. There were 32 patients with polypoid lesions and 54 with nonpolypoid tumors. RESULTS: The frozen tissue diagnosis and final diagnosis were identical in 82 of the 86 cases, that is, benign in 65 and malignant in 17. The other four cases had different diagnoses, that is, conversion from benign to malignant in two and from malignant to benign in two. The overall accuracy of frozen diagnosis was 95.3% (97.0% for benign and 94.7% for malignant). In 32 polypoid lesions, the accuracy of frozen section diagnosis was 91% (93% for benign; 89% for malignant). In 54 nonpolypoid lesions, the accuracy of diagnosis was 98% (100% for benign; 93% for malignant). The diagnosis of depth of invasion was identical only in 7 (70%) of the 10 carcinoma cases examined, while it was diverse in the remaining 3, that is, conversion from adenocarcinoma invading the subserosa to that limiting to the mucosa in one, from carcinoma within the mucosa to that infiltrating the muscle coat in one, and from carcinoma affecting the muscle layer to that invading the subserosa in the other. Alterations of frozen section diagnosis about being benign or malignant and about the depth of invasion were encountered in seven patients, five of whom had a polypoid tumor. CONCLUSIONS: The intraoperative frozen tissue diagnosis is fairly reliable as to whether lesions are malignant or benign; however, accuracy is low in patients with polypoid lesions of the gallbladder. Also, frozen section diagnosis does not reliably measure the depth of invasion of gallbladder carcinoma.

Adenocarcinoma↗

PubMed1997

Characterization of glycoproteins in the epithelial cells of human and other mammalian gallbladder. A review.

The mammalian gallbladder mucosa is lined by a simple columnar epithelium. Typical surface epithelial cells (principal cells) contain short microvilli, secretory granules, dense bodies, mitochondria and Golgi apparatus. Dense bodies are thought to be lysosomes. Secretory granules contain mucous glycoproteins which are released to the lumen by exocytosis. Oligosaccharide side chains of mucous glycoproteins may provide a favorable environment for nucleation of cholesterol in gallstone formation; therefore they have been studied during the past decades. Histochemical techniques allow the in situ identification of carbohydrates at both the cellular and subcellular levels. The oligosaccharide chains of principal cell mucous glycoproteins have been studied by classical histochemical techniques (PAS, alcian blue, HID, etc). These techniques indicate that mammalian gallbladder mucous glycoproteins are heavily sulphated, whereas sialic acid residues are scarce. Neutral mucins have not been described in the mammalian gallbladder. Electron microscopic studies have located the oligosaccharide chains in secretory granules and Golgi apparatus. More recently, lectins (molecules which specifically recognize and bind with different saccharides or saccharide sequences) have been applied for the intracellular localization of carbohydrate residues. Lectin histochemistry has detected fucose, galactose, N-acetylglucosamine, N-acetylgalactosamine and N-acetylneuraminic acid residues in mucous granules, Golgi apparatus and apical membrane of human principal cells. Mannose residues were observed only in dense bodies. The combined use of deglycosylation procedures and lectin histochemistry has revealed a variety of terminal sequences in oligosaccharide chains of gallbladder mucous glycoproteins: Neu5Ac(alpha 2-3)Gal(beta 1-3)GalNAc, Neu5Ac(alpha 2-3)Gal(beta 1-4)GlcNAc and Gal(beta 1-4)GlcNAc. This technology also suggested the occurrence of N-linked oligosaccharides in the dense bodies of principal cells. Mucous granules mainly contained mucin-type O-linked oligosaccharides although some N-linked chains have also been detected. Gallstone formation is probably a complex process depending on multiple factors. Mucous glycoproteins are one of the factors involved in this process. Histochemical methods offer an excellent research tool for the characterization of glycoproteins in the epithelial cells of the gallbladder, thus contributing to the elucidation of the pathophysiology of gallstone formation.

Animals↗

PubMed1996

Treatment of advanced adenocarcinomas of the exocrine pancreas and the gallbladder with 5-fluorouracil, high dose levofolinic acid and oral hydroxyurea on a weekly schedule. Results of a multicenter study of the Southern Italy Oncology Group (G.O.I.M.).

BACKGROUND: To date there is no established chemotherapeutic treatment for patients with unresectable locally advanced and/or metastatic carcinomas of the exocrine pancreas or the gallbladder. A multicenter Phase II trial has been performed by the Southern Italy Oncology Group with the aim of evaluating the clinical effectiveness and tolerability of weekly 5-fluorouracil (5-FU) in modulation with intravenous (i.v.) high dose levofolinic acid and oral hydroxyurea. METHODS: A total of 70 patients fulfilling the standard eligibility for a Phase II study were enrolled in the trial. Forty patients had advanced pancreatic adenocarcinoma and 30 had advanced gallbladder carcinoma. The treatment schedule was: levofolinic acid, 100 mg/m2, in 500 mL of normal saline over 2-hour infusion followed by 5-FU, 600 mg/m2 i.v. bolus, and oral hydroxyurea, 1000 mg/m2, for 1 day every week for 6 consecutive weeks followed by 15 days of rest. RESULTS: Among the 40 patients with pancreatic adenocarcinoma, 5 (12.5%; 95% confidence level [CL], 8.5-16.5%) showed a partial response with a median duration of 5.6+ months, and 13 had stable disease. Twenty-two patients progressed. Median survival was 5.8 months. Among patients with advanced gallbladder carcinoma, 9 of 30 had a partial response (30%; 95% CL, 26-34%) with a median duration of 6.5 months, and 8 (27%) had stabilization of disease. Thirteen patients showed progressive disease. Median overall survival was 8 months. Toxicity was mild, with Grade 1 to 2 leukopenia and gastrointestinal toxicity the most frequent side effects. No chemotherapy-related deaths were observed. CONCLUSIONS: 5-FU in modulation with i.v. levofolinic acid and oral hydroxyurea on a weekly schedule is well tolerated by the vast majority of patients with locally advanced and/or metastatic carcinoma of the pancreas or the gallbladder. Although response rate and overall survival for patients with pancreatic adenocarcinoma are far from acceptable, the 30% overall response rate achieved in patients with advanced gallbladder carcinoma suggests that 5-FU in modulation with levofolinic acid and hydroxyurea is active in this neoplasm. The combination of modulated 5-FU with other antineoplastic drugs seems worthy of clinical testing in further controlled trials.

Adenocarcinoma↗

PubMed1998

The National Cancer Data Base report on carcinoma of the gallbladder, 1989-1995.

BACKGROUND: Reports utilizing data from the Commission on Cancer's National Cancer Data Base (NCDB) have previously contained evaluations of time trends for stage of disease at diagnosis, treatment, and survival for multiple tumor sites. Data collected from 1989, 1990, 1994, and 1995 for carcinoma of the gallbladder are presented herein. METHODS: The data presented in this review were collected from hospital cancer registries from across the U.S. Seven calls for data yielded a total of 5,850,000 cases for the years 1985-1995, including 2574 gallbladder carcinoma cases from 1989-1990 and 2914 cases from 1994-1995 from hospital cancer registries across the U.S. These data represent approximately 8.8% and 8.4% of the estimated cases of liver and biliary track cancers diagnosed in the U.S. during the two respective time periods. RESULTS: There were no changes in patient demographics between 1989-1990 and 1994-1995. Most gallbladder carcinoma patients were white women. The documentation of tumor stage improved noticeably between the two study periods. There was no increased frequency in the occurrence of early stage tumors between the two reporting times, an era that saw the development and widespread application of laparoscopic cholecystectomy. Treatment differed according to stage of disease. Surgery alone, particularly nonradical surgery, was performed more frequently in the initial treatment of gallbladder carcinoma. A large percentage of gallbladder carcinoma patients received no definitive therapeutic intervention because of the advanced stage of disease at presentation and the lack of effective treatments for these cancers. Multimodality treatment was utilized more often for young patients. Survival was closely related to tumor stage, with 60% 5-year survival for Stage 0 patients, 39% for Stage I patients, and 15% for Stage II patients, but only 5% for Stage III patients and 1% for Stage IV patients. Patient outcome was not demonstrably affected by more aggressive therapy, nor was an adverse effect in results seen in early stage cancers between 1989-1990 and 1994-1995. CONCLUSIONS: The NCDB data are valuable in the evaluation of trends in malignant diseases, treatments, and patient survival. No substantial differences were apparent in the diagnosis, treatment, and survival of patients during this 7-year study period. The data do not support any adverse effect on outcome results with the introduction of laparoscopic cholecystectomy in the U.S.

Aged↗

PubMed1976

Carcinoma of the gallbladder: staging, treatment, and prognosis.

Sixty-six cases of carcinoma of the gallbladder treated at The Memorial Hospital, Danville, Virginia, and the Medical College of Virginia, Richmond, were staged according to depth of invasion and spread and graded histologically; the findings were correlated with survival. Results from the two hospitals were essentially identical and the survival figures correlated well with 399 reported cases in the medical literature which could be staged according to the depth of invasion. A simple method combining staging and histologic grading of cancer of the gallbladder, which can easily be applied to all cancers of the gallbladder removed surgically and which should prove useful in the management of this disease, is described. Essentially all of the carcinomas of the gallbladder in the series were incidental findings at surgery for gall stones which may explain a relatively high proportion of superficial carcinomas which are cured by the removal of the gallbladder.

Gallbladder Neoplasms↗