J.Jpn. Surg. Soc.. 88(9): 1354-1357, 1987
Report on the annual meeting
THE SURGICAL TREATMENT OF THE ADVANCED CARCARCINOMA OF THE GALLBLADDER
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First Department of Surgery, Niigata University School of Medicine, Niigata, Japan Hidehiro Kawaguchi, Keisuke Yoshida, Yoshio Shirai, Yoshikazu Fukuda, Mamoru Sasagawa, Terukazu Muto, Katsuyuki Uchida |
The pathological findings and prognosis were studied in forty patients who underwent resection of advanced carcinoma of the gallbladder in our hospital. The rate of lymph node metastasis was 69％ in all patients studied. By the Kaplan-Meier method, the five-year survival rate was 89％ in patients of stage II and 48％ in stage III. The three-year survival rate of the patients whose primary tumor was localized in the wall of the gallbladder was 81.6％ following our extended cholecystectomy with systemic lymph node dissection. On the other hand, the prognosis of the patients with direct extension of carcinoma into the cystic duct and/or hepato-duodenal ligament was poor.
It was concluded that extended cholecystectomy with at least systemic lymph node dissection (R2) was essential for patients with advanced carcinoma of the gallbladder. When the cystic duct or the structures of hepato-duodenal ligament was involved, more extensive surgery including pan-creatoduodenectomy and more extensive lymph node dissection (R3) should be performed.
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