Papillary carcinoma of the gallbladder and anomalous pancreatico-biliary junction. Report of three cases and review of the literature.
OBJECTIVE
Papillary carcinoma of the gallbladder is less invasive, less frequently metastasizes and results in a longer survival than other gallbladder tumors. It is frequently associated with Anomalous Pancreatico-biliary junction (APBJ), a malformation that occurs most frequently in Japan. Consequently, most cases of papillary cancer have been reported in the Japanese literature, while the incidence of this neoplasm, and its association with APBJ, is still unknown in Western Countries.


METHODS
Seventy cases of gallbladder cancer, observed between January 1992 and December 2000, were retrospectively evaluated. All the histological sections and available cholangiograms were reviewed.


RESULTS
Three cases of papillary carcinoma were found (4.2%); APBJ was detected in one of these. All patients underwent resection and are long-term survivors; one patient developed, three years later, a papillary cancer of the common bile duct and was treated by Whipple's procedure.


CONCLUSIONS
This study provides evidence that papillary carcinoma is more rare in Western countries than in Japan and it is characterized by a longterm survival after surgical resection. Further studies and reports are necessaries to define if this different incidence can justify differences between Western and Japanese results after surgery for gallbladder cancer.
Department of Surgery (Hepatobiliary Unit), Catholic University of Sacred Heart, A. Gemelli School of Medicine, Rome, Italy.
Gennaro
G
Nuzzo
Gennaro
G
Clemente
Federica
F
Cadeddu
Francesco
F
Ardito
Riccardo
R
Ricci
Fabio M
FM
Vecchio
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001652:Bile Ducts / Q000002:abnormalities*; D002291:Carcinoma, Papillary / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D005260:Female; D005706:Gallbladder Neoplasms / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D006801:Humans; D007558:Italy; D008297:Male; D010183:Pancreatic Ducts / Q000002:abnormalities*; D012189:Retrospective Studies