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Should the extrahepatic bile duct be resected or preserved in R0 radical surgery for advanced gallbladder carcinoma? Results of a Japanese Society of Biliary Surgery Survey: a multicenter study.
[carcinoma of the gallbladder]
We
assessed
the
significance
of
an
extra
bile
duct
resection
by
comparing
the
survival
of
patients
with
advanced
gallbladder
carcinoma
who
had
resected
bile
ducts
with
those
who
had
preserved
bile
ducts
.
A
radical
cholecystectomy
that
includes
extra
bile
duct
resections
has
been
performed
without
any
clear
evidence
of
whether
an
extra
bile
duct
resection
is
preventive
or
curative
.
We
conducted
a
questionnaire
survey
among
clinicians
who
belonged
to
the
114
member
institutions
of
the
Japanese
Society
of
Biliary
Surgery
.
The
questionnaires
included
questions
on
the
preoperative
diagnosis
,
complications
,
treatment
,
and
surgical
treatment
,
resection
procedures
,
surgical
results
,
pathological
and
histological
findings
,
mode
and
site
of
recurrence
,
and
the
need
for
additional
postoperative
treatment
.
A
total
of
4243
patients
who
had
gallbladder
carcinoma
and
were
treated
from
January
1
,
1994
to
December
31
,
2003
were
identified
.
The
838
R
0
patients
with
pT
2
,
pT
3
,
and
pT
4
advanced
carcinoma
of
the
gallbladder
for
which
there
was
no
cancer
invasion
to
the
hepatoduodenal
ligament
or
cystic
duct
in
the
final
analysis
.
The
5
-
year
cumulative
survival
,
postoperative
complications
,
postoperative
lymph
node
metastasis
,
and
local
recurrence
along
the
hepatoduodenal
ligament
were
not
substantially
different
between
the
resected
bile
duct
and
the
preserved
bile
duct
groups
.
Our
retrospective
questionnaire
survey
showed
that
an
extrahepatic
bile
duct
resection
had
no
preventive
value
in
some
patients
with
advanced
gallbladder
carcinoma
in
comparison
to
similar
patients
who
had
no
such
bile
duct
resection
.
An
extrahepatic
bile
duct
resection
may
therefore
be
unnecessary
in
advanced
gallbladder
carcinoma
without
a
direct
infiltration
of
the
hepatoduodenal
ligament
and
the
cystic
duct
.
Diseases
Validation
Diseases presenting
"cancer"
symptom
achondroplasia
acute rheumatic fever
adrenal incidentaloma
alpha-thalassemia
benign recurrent intrahepatic cholestasis
cadasil
canavan disease
carcinoma of the gallbladder
cholangiocarcinoma
coats disease
congenital adrenal hyperplasia
congenital diaphragmatic hernia
cowden syndrome
cushing syndrome
cutaneous mastocytosis
dedifferentiated liposarcoma
dystrophic epidermolysis bullosa
epidermolysis bullosa simplex
erdheim-chester disease
erythropoietic protoporphyria
esophageal adenocarcinoma
esophageal carcinoma
esophageal squamous cell carcinoma
familial hypocalciuric hypercalcemia
familial mediterranean fever
gm1 gangliosidosis
heparin-induced thrombocytopenia
hereditary cerebral hemorrhage with amyloidosis
hirschsprung disease
hodgkin lymphoma, classical
inclusion body myositis
junctional epidermolysis bullosa
kabuki syndrome
kallmann syndrome
kindler syndrome
lamellar ichthyosis
liposarcoma
locked-in syndrome
lymphangioleiomyomatosis
monosomy 21
neuralgic amyotrophy
oculocutaneous albinism
oligodontia
oral submucous fibrosis
papillon-lefèvre syndrome
pendred syndrome
pleomorphic liposarcoma
primary effusion lymphoma
proteus syndrome
pyomyositis
pyruvate dehydrogenase deficiency
severe combined immunodeficiency
sneddon syndrome
systemic capillary leak syndrome
triple a syndrome
von hippel-lindau disease
waldenström macroglobulinemia
well-differentiated liposarcoma
werner syndrome
wiskott-aldrich syndrome
wolf-hirschhorn syndrome
x-linked adrenoleukodystrophy
This symptom has already been validated