| Theme |
The Current Status of Management of Gallbladder Cancer |
| Title |
Surgical Treatment for Gallbladder Cancer |
| Author |
Taku Aoki |
Second Department of Surgery, Dokkyo Medical University |
| Author |
Keiichi Kubota |
Second Department of Surgery, Dokkyo Medical University |
| [ Summary ] |
Extension of the primary tumor (T factor) and lymph node (LN) metastasis (N factor) are two strong predictors of survival after resection of gallbladder cancer (GBC). As it remains difficult to diagnose the N factor before resection, the surgical procedure is generally determined according to the T factor based on imaging findings. For T1 stage GBC, simple cholecystectomy with LN sampling is the recommended procedure. Favorable postoperative outcomes have been reported. For T2 stage GBC, extended cholecystectomy with lymphadenectomy is generally recommended aiming at obtaining R0 resection. However, some controversies exist regarding the extent of lymphadenectomy and extra-hepatic bile duct resection. For T3 and T4 GBC, aggressive surgical approaches have been applied. However survival outcomes remain unfavorable, though improved short- and long-term outcomes have been reported. The indications for extended surgical resection for advanced GBC should be cautiously judged while balancing the surgical risk and survival benefits. Development of multidisciplinary treatments are urgently needed for advanced GBCs. |