Abstract
A 50-year old woman had cancer in the gallbladder neck and massive lymph node metastases that invaded the pancreas head, extending toward the common hepatic artery, the portal vein which was resected partially, the superior mesenteric artery, the inferior vena cava and the right renal artery (#8ap, #9, #14a and #16a2). Extended cholecystectomy was performed and the massive lymph node metastases were removed altogether through pylorus-preserving pancreaticoduodenectomy. A metastatic nodule in the left lobe of the liver (S2) was also resected. Histologically they were poorly differentiated tubular adenocarcinoma (Hinf1, Binf2, N3, H1, StageIVb). Four years later, a para-aortic recurrent lymph node (#16b1) was detected by a follow-up CT scan and was removed surgically. Each operation was followed by chemotherapy with cisplatin and 5Fu. She is still alive as of 15 years after the first operation. Her well-being for 15 years after the first operation is a rare success of thoroughgoing surgical management against far advanced gallbladder cancer.
