Korean Journal of Hepato-Biliary-Pancreatic Surgery  2009;13(2):84-88

Extent of Surgical Resection in Gallbladder Cancer.

Sang Jae PARK 1

Affiliations

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Keywords

Gallbladder Cancer; Surgery; Surgical Resection

Country

Republic of Korea

Language

Korean

Abstract

Gallbladder (GB) cancer is a fatal disease for which the only chance for cure is surgical resection. The primary goal of surgery in GB cancer is to achieve zero residual tumor microscopically (R0 resection) and to be safe. However, there are still debates about the extent of surgery in GB cancer. For determining the extent of liver resection, tumor factors such as T-stage, tumor growth pattern and location as well as patients factors such as age, presence of liver cirrhosis and co-morbidity should be considered together. The extent of lymph node (LN) dissection in GB cancer is still inconclusive, and dissection of LN group 12, 13a and 8 can be regarded as the standard LN dissection. There is little evidence that extended lymph node dissection enhances survival. Acceptable indications for combined resection of the bile duct are direct invasion of the bile duct or cystic duct stump, and presence of LN metastasis in LN group 12. Routine pancreatoduodenectomy for extended LN dissection in GB cancer is not recommended.