An Examination of Hepatectomy for Gallbladder Cancer with Subserosal Invasion Based on Clinicopathological Findings

Yuko Mataki, Sonshin Takao, Hiroyuki Shinchi, Kousei Maemura, Shinichirou Mori and Takashi Aikou

Department of Surgical Oncology and Digestive Surgery, Field of Oncology Kagoshima University Graduate School of Medical and Dental Sciences

Introduction: We studied hepatectomy for gallbladder cancer with subserosal invasion (ss cancer). Methods and Results: Subject were 21 patients with ss cancer undergoing curative surgery who were analyzed based on pathological factors, survival length and hepatic metastasis. Ss cancer with expansive progression or slight invasion to the subserosal layer involved slight vascular, hepatic, and biliary invasion, similar to early gallbladder cancer. There was no significant survival rate between more than segmental resection and less than segmental resection for ss cancer, because more than segmental resection was selectively done in more invasive cases. Two of five cases surviving 5 years had vascular invasion and more severe invasion to the subserosal layer but were prevented from hepatic metastasis by more than segmental resection. Two other cases with no vascular invasion and slight invasion to the subserosal layer survived beyond 5 years with cholecystectomy alone. Among six cases performed cholecystectomy alone, three cases had hepatic metastasis and the metastatic sites were S4a and S5. This fact threw a doubt on rational hepatectomy in the first operation for ss cancer. Conclusions: S4a and S5 segmentectomy for ss cancer has great significance for localized hepatic metastasis.

Key words
gallbladder cancer, subserosal invasion, hepatectomy, hepatic metastasis

Reprint requests
Yuko Mataki Department of Surgical Oncology and Digestive Surgery, Field of Oncology, Kagoshima University Graduate School of Medical and Dental Sciences
8-35-1 Sakuragaoka, Kagoshima, 890-8520 JAPAN

Accepted
October 29, 2003

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