In:
Digestive Surgery, S. Karger AG, Vol. 28, No. 2 ( 2011), p. 148-153
Abstract:
〈 i 〉 Background: 〈 /i 〉 Extended liver resection is necessary for advanced gallbladder cancer with hepatic involvement to achieve R0 resection. However, its type or extent and its surgical technique have yet to be established. 〈 i 〉 Methods: 〈 /i 〉 To exclude systemic disease, frozen section biopsy following systematic para-aortic lymphadenectomy is recommended before starting extended surgery with curative intent because para-aortic nodes are involved more frequently than expected. Right hepatectomy with biliary reconstruction should be indicated for the hepatic hilum type of advanced gallbladder cancer in which a relatively small tumor in the gallbladder neck infiltrates the hepatic hilum and causes obstructive jaundice. Ventral hepatectomy without biliary reconstruction can be applied for the hepatic bed type in which a large mass in the gallbladder fundus and body penetrates into the hepatic parenchyma through the gallbladder bed. 〈 i 〉 Results: 〈 /i 〉 The two types of extended liver resection were successfully performed in representative cases. Detailed procedures were described. Long-term survival without disease recurrence has been achieved in both cases. 〈 i 〉 Conclusion: 〈 /i 〉 The type of extended liver resection should be chosen according to the mode of tumor spread in advanced gallbladder cancer without distant metastasis.
Type of Medium:
Online Resource
ISSN:
0253-4886
,
1421-9883
Language:
English
Publisher:
S. Karger AG
Publication Date:
2011
detail.hit.zdb_id:
1468560-7
