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Carcinoma of the gallbladder is rare in Western countries but more common in India and Mexico. It is associated with gallstones in up to 85% of cases, with the risk of malignancy increasing with the length of time that gallstones have been present. It is found in less than 1% of gallbladder operations. The tumour presents predominantly in women, and patients are usually in their seventies.
The majority of primary tumours are adenocarcinomas, either scirrhous (60%), papillary (25%), or mucoid (15%). Spread of tumour occurs early by direct invasion of the liver and hilar structures and by metastases to the common duct nodes, liver and lungs. Most symptomatic patients have metastases.