From 1960 to 1975 in the Surgical Clinic of the Medical Academy Erfurt altogether 77 patients with a primary malignoma of the gall-bladder were observed. Symptomatology and findings are non-characteristic. 64 times a laparotomy was carried out, whereby in 51 cases the intervention had to be finished as test laparotomy. 13 times a cholecystectomy or a biliodigestive anastomosis was carried out. The average survival time of the patients with test laparotomy was 53 days. A survival time of more than one year could nertainty. Issuing from this the author adopts a definite attitude to carcinogenesis and the importance of lithiasis.