J.Jpn. Surg. Soc.. 120(2): 189-195, 2019

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Feature topic

SURGICAL TREATMENT FOR PERIHILAR VASCULAR INVASION IN GALLBLADDER CANCER

Surgery is the only curative treatment for biliary tract cancer. According to the clinical practice guidelines, for perihilar vascular invasion (PVI) of biliary cancer, portal vein (PV) excision may be useful, but the significance of hepatic artery (HA) resection is unclear. We conducted a review of vascular resection for PVI of gallbladder cancer (GBC). In Pubmed, we searched for “gallbladder,” “cancer/carcinoma,” and “vascular/portal vein/hepatic artery” as key words with “title/abstract.” Ten articles were selected. In patients with PVI of GBC, preoperative jaundice (90-100％) and hepatoduodenal ligament infiltration were observed. Although there were few reports on vascular resection for GBC, the morbidity rates in patients with PV and HA resection were 69-78％ and 60％ and in-hospital mortality rates were 0-60％ and 0％, respectively. The 5-year survival rates after PV and HA resection were 0-33％ and 0％, median survival times were 18 and 13.9 months, and actual 5-year survival was seen in 6 and 0 cases, respectively. High hospital mortality and low survival rates were reported after vascular resection for PVI of GBC. However, surgical outcomes are expected to improve by selecting cases for resection with careful consideration of safety and curability at specialized facilities in combination with chemotherapy.

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