Clinical Study of 12 Cases of T2 (SS) Gallbladder Cancer Who Underwent Additional Resection

• Published in: Tando Vol. 37; no. 2; pp. 155 - 161
• Main Authors: Mori, Yukihiro, Kitagawa, Hirohisa, Muto, Jun, Hashida, Kazuki, Kawamoto, Kazuyuki
• Format: Journal Article
• Language: Japanese
• Published: Japan Biliary Association 31.05.2023
• Subjects: additional resection; gallbladder cancer; T2 gallbladder cancer; two-stage resection
• ISSN: 0914-0077; 1883-6879
• DOI: 10.11210/tando.37.155

We examined 12 patients who were diagnosed pT2 gallbladder cancer after initial cholecystectomy and underwent additional resection. Median age was 75 years. Preoperative diagnosis was cT1 cancer in 2 cases, and benign disease in 10 cases. Usual cholecystomy was selected for 5 cases and whole layer resection was selected for 6 cases, subtotal resection was selected for 1 case. All patients underwent additional resection: 7 hepatectomies, 7 extrahepatic bile duct resections, 11 resional lymph node resections, 11 R0 resections. There were no postoperative complications beyond Clavien-Dindo IIIa, and median postoperative hospital stay was 10.5 days. Histological residual cancer was diagnosed in 3 cases, and postoperative adjuvant chemotherapy was administered in 3 cases. Two cases relapsed, and 5-year RFS was 81.5% and 5-year OS was 91.7%, which were considered equivalent or better than previous reports. Based on the Japanese clinical trial, S-1 is expected to become the standard postoperative treatment and improve the prognosis in the future. At the time of cholecystectomy, gallbladder cancer should always be considered. If pT2 gallbladder cancer is revealed after initial cholecystectomy, two-stage additional resection and proper postoperative adjuvant chemotherapy is considered useful to achieve good prognosis.