Abstract
For early stage or highly suspected malignant lesion of the gallbladder, surgical resection via the open approach is recommended, because the dissection plane on the liver side is within the subserosal layer in conventional laparoscopic cholecystectomy. However, we confirmed histologically that the subserosal layer could be dissected completely enveloped by a fibrous membrane by dissection, leaving Laennec's capsule in the liver bed. Then, we performed whole layer cholecystectomy with regional lymph-node dissection via a laparoscopic approach, which had been standardized by resolving some unsafe aspects, in 7 patients and achieved good results. Our standardized procedure can be performed without bleeding from the liver bed and enveloping the subserosal layer by membranous tissue. It has the potential to become the standard procedure for early stage or highly suspected malignant lesion of the gallbladder.
