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Abstract primary gall bladder cancers are relatively uncommon, accounting for <1% of all cancers and <10% of all G.I.T Cancers, (Lotze et al.,1993.) The highest incidences are reported in Chileans, Bolivians, Central Europeans, Israelis, American Indians, and Americans of Mexican origin ,(Lazcano-Ponce.,2001). Epidemiology of gallbladder cancer is closely linked to the epidemiology of gallbladder stones, (Zatonski.,1993). The clinical presentation of gallbladder cancer is identical to the symptoms of biliary colic or chronic cholecystitis. Ultrasonographic examination is the initial radiologic evaluation for symptoms of right upper quadrant pain, a gallbladder-replacing or invasive mass was present in 50% of patients with gallbladder cancer examined,( Wibbenmeyer etal.,1995). Cancer spreads early by lymphatic metastasis, hematogenous metastasis, and direct invasion into the liver. In general, the prognosis of patients with gall bladder cancers is poor, with overall 5 year survival rates less than 10% ,(lotze,et al.,1993). Surgery in the form of complete resection remains the mainstay of treatment, (misra,et al.,2003), The standard surgery is a cholecystectomy with nodal clearance, for patients with stages I - III disease . |