Current Curative Surgical Management of Gallbladder Cancer: A Brief Review

Abstract

Gallbladder cancer has a dismal prognosis, radical surgical resection offers the only chance of cure, but it is possible in only small proportion due to advanced disease and the recurrence is high. The extent of resection depends on the extent of disease. The aim of any therapeutic operation must be the radical removal of the tumor with no residual disease (R0 resection). Crucial for the surgical strategy is the TNM staging and the planning is decided in accordance with the T stage. In T1a simple cholecystectomy is considered as an adequate treatment. In T1b there is a controversy; some advocate simple cholecystectomy and others more extensive radical cholecystectomy. In T2 either extended radical cholecystectomy or resection of liver segments IVb and V. In all cases a radical lymph node dissection along the hepatoduodenal ligament is needed additionally. In T3 either hepatic segmentectomy IVb and V at least or extended right hepatectomy, both combined always with radical lymph node dissection. In T4 usually palliative operation; an extensive en-block resection with removal of included organs is rarely attempted.




doi:10.4021/jcs50w