J.Jpn. Surg. Soc.. 88(9): 1324-1328, 1987

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Report on the annual meeting

SPREADING MODES OF CARCINOMA OF THE GALLBLADDER AND IT'S TREATMENT

The mortality after resection of carcinoma of the gallbladder is quite high. For this high mortality, several possible factors have been proposed. One of the reasons is that carcinoma of the gallbladder spreads quite rapidly through lymph vessels and perineural spaces.
Spreading types of carcinoma of the gallbladder were retrospectively studied in cases which underwent resection of carcinoma of the gallbladder in our department between October, 1983 and January, 1987.
In 9 cases whose carcinomas located at the fundus or body, the perineural invasions and invasions through lymph vessels were negative in 8 cases and all have survived except one. In 14 cases whose carcinomas invaded to the neck of the gallbladder or cystic duct, the perineural invasion and invasion through lymph vessels were commonly seen and only 4 cases have survived.
The following conclusions were obtained.
1) In the cases whose carcinomas of the gallbladder located at the fundus or body, the gallbladder and bile duct should be removed with the underlying liver tissue in depth of 2cm.
2) In the cases whose carcinoma of the gallbladder invaded to the neck or cystic duct, pancreatoduodenectomy should be performed for the purpose of dissection of regional lymph nodes.

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