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Hepatic resection in 485 R0 pT2 and pT3 cases of advanced carcinoma of the gallbladder: results of a Japanese Society of Biliary Surgery survey--a multicenter study.
[carcinoma of the gallbladder]
We
conducted
this
study
to
evaluate
the
optimal
hepatic
resection
for
pT
2
and
pT
3
advanced
carcinoma
of
the
gallbladder
without
invasion
of
the
hepatoduodenal
ligament
.
We
conducted
a
questionnaire
survey
regarding
4
,
243
cases
of
carcinoma
of
the
gallbladder
treated
during
the
recent
10
-
year
period
at
112
institutions
belonging
to
the
Japanese
Society
of
Biliary
Surgery
.
The
questionnaires
included
questions
on
preoperative-diagnosis
,
complications
,
treatment
,
and
surgical
treatment
,
procedures
of
resection
,
surgical
result
,
path
histological
findings
,
mode
,
and
site
of
recurrence
,
additional
post-operative
treatment
.
They
included
293
pT
2
and
192
pT
3
R
0
cases
,
which
were
negative
for
hepatoduodenal
ligament
invasion
,
and
the
cumulative
survival
rates
and
sites
of
postoperative
recurrence
in
the
form
of
liver
metastasis
,
were
retrospectively
analyzed
in
these
485
cases
.
There
were
no
significant
differences
in
survival
rate
or
recurrence
rates
in
the
form
of
liver
metastasis
between
the
groups
that
underwent
resection
of
the
gallbladder
bed
,
the
group
that
underwent
segmentectomy
4
a
+
5
,
and
the
group
that
underwent
hepatectomy
in
patients
with
of
both
pT
2
or
pT
3
gallbladder
cancers
.
Our
results
also
did
not
show
that
liver
metastasis
to
segment
4
a
5
alone
was
particularly
common
.
For
gallbladder
cancer
,
neither
with
hepatoduodenal
ligament
invasion
nor
hepatic
invasion
,
resection
of
the
gallbladder
bed
is
more
preferable
for
surgical
hepatic
procedure
.
For
gallbladder
cancer
that
invades
any
hepatic
sites
,
a
hepatic
surgical
procedure
that
could
eliminate
surgical
margins
would
be
desirable
.
Diseases
Validation
Diseases presenting
"gallbladder bed"
symptom
carcinoma of the gallbladder
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