RESUMO
Operations were carried out on 41 patients with carcinoma of the gallbladder. Coexistent cholelithiasis was encountered in all cases. Ultrasonic examination (USE) and computed tomography (CT) are the most informative methods of preoperative diagnosis. With the use of both methods the correct diagnosis was made in 100% of cases. The true diagnosis was made before the operation in 73% of cases. In 9 patients the correct diagnosis was established only during the operation. Two patients underwent operation for calculous cholecystitis, stage I gallbladder carcinoma was identified during planned histological study. Among 32 patients 2 were found to have stage I, one--stage II, 17--stage III, and 12 patients--stage IV of the disease. Radical operations were carried out on patients with stages I and II and on 7 patients with stage III of the disease. Nine patients (28%) died in the immediate postoperative period. Cholecystectomy with careful removal of the elements of the gallbladder bed should be considered the radical operation for stage I of the disease; in stage II the operation should be supplemented by lymphadenectomy along the course of the hepatoduodenal ligament. Hemihepatectomy or atypical resection of the liver is indicated in stage III of the disease.
