Abstract
We defined early carcinomas of the gallbladder as those with histologic invasion into the mucosa layer (m) or muscularis propria (pm), and 8 cases experienced at our department were studied on the diagnosis and operative procedures. Of these 8 cases, histologic invasion was evaluated as m in 6 and pm in 2 cases. Preoperatively seven were diagnosed as cholelithiasis and one as having a gallbladder polyp, no cases being diagnosed as carcinoma of the gallbladder. Correct diagnosis could be attained with intraoperative frozen section in 2 cases which had both torous tumors macroscopically with sizes of 0.5 cm and 1.7 cm respectively. The other 6 cases were diagnosed as carcinoma by postoperative histopathological examination. Macroscopically 5 of the 6 cases had flat tumors and the remaining one had a 0.5 cm torous type which was evaluated as benign during surgery. As to operative procedures, one of the 2 diagnosed intraoperatively underwent cholecystectomy and lymph node dissection add by excision of liver floor, because we had difficulty in evaluating the invasion at the site of liver floor. The remaining one, which had a tumor locating at the site of abdominal cavity, underwent cholecystectomy and lymph node dissection. Postoperative histopathologic examination revealed that the both carcinomas were of invasion depth of m and n (-). On the other hand, of 6 cases diagnosed postoperatively (m: 4; pm: 2), 4 with invasion of m did not received additional operation in two-step approach. In 2 cases of invasion depth of pm, one in which carcinoma was located in the liver floor was added excision of liver floor and lymph node dissection. Other one case of pm, locating at the peritoneal site, no additional operation was performed. All cases were n (-) and have been alive.
