J.Jpn. Surg. Soc.. 88(9): 1347-1349, 1987
Report on the annual meeting
OPERATIVE PROCEDURES FOR ADVANCED GALLBLADDER CARCINOMA
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Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical College, Tokyo, Japan Tatsuya Yoshikawa, Fujio Hanyu |
We studied the operative procedures for advanced gallbladder carcinoma from the viewpoint of infiltration to the hepatoduodenal ligament and lymph node metastasis.
Infiltration to the hepatoduodenal ligament was seen in 39％of the resected cases. Since lymphatic invasion and perineural invasion within the ligament were seen in all of the cases, it was considered that pancreatoduodenectomy or in some cases en block resection of the hepatoduodenal ligament was necessary for complete skeletonization of that portion.
Lymph node metastases were seen in 68％of the resected cases. Since lymph node metastase of the posterior region of the head of the pancreas and along the superior mesenteric artery Plural seen in 70％ of the cases with infiltration of other organs and in 33％ of the cases with involvement of the neck of the gallbladder or involvement exceeding two-thirds of the gallbladder even if it was confined to the subserosa, it was considered that pancreatoduodenectomy was necessary in these cases for the purpose of lymph node dissection.
We emphasized that pancreatoduodenectomy along with hepatectomy should be performed in cases with involvement confined to the subserosa for improvement of surgical results of gallbladder carcinoma.
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