Hepatic resection in 485 R0 pT2 and pT3 cases of advanced carcinoma of the gallbladder: results of a Japanese Society of Biliary Surgery survey—a multicenter study

• Published in: Journal of Hepato‐Biliary‐Pancreatic Surgery Vol. 16; no. 2; pp. 204 - 215
• Main Authors: Araida, Tatsuo, Higuchi, Ryouta, Hamano, Mie, Kodera, Yoshihito, Takeshita, Nobuhiro, Ota, Takehiro, Yoshikawa, Tatsuya, Yamamoto, Masakazu, Takasaki, Ken
• Format: Journal Article
• Language: English
• Published: Japan Springer Japan 01.03.2009
• Subjects: Abdominal Surgery; Aged; Carcinoma - epidemiology; Carcinoma - pathology; Carcinoma - surgery; Female; gallbladder carcinoma; Gallbladder Neoplasms - epidemiology; Gallbladder Neoplasms - pathology; Gallbladder Neoplasms - surgery; Gastroenterology; Hepatectomy - methods; hepatic resection; Hepatology; Humans; Japan - epidemiology; Male; Medicine; Medicine & Public Health; Middle Aged; Neoplasm Staging; Original Article; Postoperative Complications; Practice Patterns, Physicians' - statistics & numerical data; resection of the gallbladder bed; Retrospective Studies; right hepatectomy; segmentectomy 4a+5; Surgical Oncology; Surveys and Questionnaires; Survival Rate; Treatment Outcome; Japan; Segmentectomy 4a+5; Resection of the gallbladder bed; Right hepatectomy; Hepatic resection; Gallbladder carcinoma
• ISSN: 0944-1166; 1436-0691; 1868-6982
• DOI: 10.1007/s00534-009-0044-3

Purpose We conducted this study to evaluate the optimal hepatic resection for pT2 and pT3 advanced carcinoma of the gallbladder without invasion of the hepatoduodenal ligament. Methods We conducted a questionnaire survey regarding 4,243 cases of carcinoma of the gallbladder treated during the recent 10-year period at 112 institutions belonging to the Japanese Society of Biliary Surgery. The questionnaires included questions on preoperative-diagnosis, complications, treatment, and surgical treatment, procedures of resection, surgical result, path histological findings, mode, and site of recurrence, additional post-operative treatment. They included 293 pT2 and 192 pT3 R0 cases, which were negative for hepatoduodenal ligament invasion, and the cumulative survival rates and sites of postoperative recurrence in the form of liver metastasis, were retrospectively analyzed in these 485 cases. Result There were no significant differences in survival rate or recurrence rates in the form of liver metastasis between the groups that underwent resection of the gallbladder bed, the group that underwent segmentectomy 4a+5, and the group that underwent hepatectomy in patients with of both pT2 or pT3 gallbladder cancers. Our results also did not show that liver metastasis to segment 4a5 alone was particularly common. Conclusion For gallbladder cancer, neither with hepatoduodenal ligament invasion nor hepatic invasion, resection of the gallbladder bed is more preferable for surgical hepatic procedure. For gallbladder cancer that invades any hepatic sites, a hepatic surgical procedure that could eliminate surgical margins would be desirable.