2018 Volume 32 Issue 1 Pages 44-50
Current image diagnosis and surgical treatment for gallbladder cancer was reviewed, especially as to early-stage cancer, the mode of hepatic spread, and the extent of lymphadenectomy. It is necessary to understand the concept and the morphological features of early gallbladder cancer in the management of this disease entity. Simple cholecystectomy is appropriate treatment for early gallbladder cancer only if tumor is absent at the margin of the cystic duct. In the preoperative diagnosis and staging of gallbladder cancer, it is important to understand the usefulness and limitations of various imaging modalities. Direct liver invasion and portal tract invasion are the main modes of hepatic spread from resectable gallbladder cancer and portal tract invasion mainly results from lymphatic spread within the portal tracts. Hepatectomy margin should be decided to remove the main tumor and its adjacent microscopic portal tract invasion when performing radical resection for gallbladder cancer. Rational extent of lymphadenectomy for gallbladder cancer should include regional lymph nodes including No. 13a nodes defined by the 6th edition of the Japanese TNM classification.
