Abstract
We investigated clinicopathological factors and prognosis for appropriate operation for 44 patients who received resections for gallbladder carcinoma with subserosal invasion. Their 5-year survival rate was 50.2%. There was a significant difference in the survival rate between the patients with and without hepatectomy, whereas there was no survival advantage for the anatomical liver resection or partial hepatectomy group cornpared with the extended cholecystectomy group. However, the 3-year survival rate of patients who underwent pancreaticoduodenectomy was 83.3%; the outcome after pancreaticoduodenectomy was comparable to that after resection of the bile duct. A significant difference in the survival rate was observed between lympahadectomy with D2 and D0/1. In particular, the tendency was remarkable in the gallbladder neck and cystic duct carcinoma. The significance of anatomical liver resection, pancreaticoduodenectomy, and resection of the bile duct was indistinct. The presence of lymph node metastasis was an independent prognostic factor by multivariate analyses. These results suggest that radical resection with hepatectomy and lympahadectomy with D2 is the appropriate procedure for gallbladder carcinoma with subserosal invasion.
