SURGICAL TREATMENT FOR GALLBLADDER CARCINOMA: A STUDY OF RESECTED CASES

Therapeutic principle and problems in the treatment of gallbladder cancer were studied on the basis of operative results in 24 patients with resected gallbladder cancer (rate of resection: 55.8%). According to macroscopic findings, tumor size and infiltration into the surrounding region tended to increase with the depth of invasion. In terms of cancerous extension, no metastasis or infiltration was found in patients with m or pm cance, while patients with cancer of ss or higher stage had the highest frequency of lymph node metastasis, followed by intrahepatic direct infiltration and bile duct infiltration, in that order. Patients with s cancer presented particularly high levels of extension. Studies of surgical procedure in relation to prognosis indicated that simple cholecystectomy (R2) may be required for treating patients with pm cancer bacause recurrent cases were found among them and intraoperative differential diagnosis remains difficult. Patients with as cancer presented various patterns of extension and stage of progression, achieving ling-term survival in some cases. Improved prognosis may be expected by actively applying extended operation (R2-3) according to the stage of progression. Cases with s cancer showed poor prognosis irrespective of surgical procedure, indicating the need for careful consideration in applying extended operation.