J.Jpn. Surg. Soc.. 89(7): 1040-1048, 1988

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Original article

A PATHOLOGICAL STUDY OF RELATIVELY EARLY STAGE CANCERS OF THE GALLBLADDER, AND THE MEANING OF THE FULL-THICKNESS CHOLECYSTECTOMY

The mode of extention of relatively early-stage gallbladder cancer (ss) was studied by microscopic serial sections in 25 patients. We also investigated the detached surface of the liver bed and gallbladder wall. No intrahepatic infiltration was noted in ss cancer and no recurrence occurred in the liver bed surface when a full-thichness resection was performed. The ss cancers in the fundus and in the body were found to extend subserously in the direction of the cervix or circumferentially. The infiltration reached the surrounding area of the common hepatic duct in 3 cases. Mucosal expantion showed the same directional tendency, but usually did not reach the cystic duct. On the other hand, the ss cancers of the cervix and the cystic duct frequently showed subserosal extention into the periductal interstitial tissue in the hepatoduodenal ligament. These results suggest that recurrence of ss cancers of the fundus and body after simple cholecystectomy might be partially caused by incomplete resection of the liver bed portion of the gallbladder wall and a full-thichness cholecystectomy for cholecystlithiasis was considered to be useful to decrease the risk of recurrence of occult gallbladder carcinoma.

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