[A pathological study of relatively early stage cancers of the gallbladder, and the significance of the full thickness cholecystectomy].
The mode of extension of relatively early-stage gallbladder cancer(ss) was studied by microscopic serial sections in 25 patients. We also investigated the detached surface of the liver bed and gallbladder wall. No intrahepatic infiltration was noted in ss cancer and no recurrence occurred in the liver bed surface when a full-thickness resection was performed. The ss cancers in the fundus and in the body were found to extend subserously in the direction of the cervix or circumferentially. The infiltration reached the surrounding area of the common hepatic duct in 3 cases. Mucosal expansion showed the same directional tendency, but usually did not reach the cystic duct. On the other hand, the ss cancers of the cervix and the cystic duct frequently showed subserosal extension into the periductal interstitial tissue in the hepatoduodenal ligament. These results suggest that recurrence of ss cancers of the fundus and body after simple cholecystectomy might be partially caused by incomplete resection of the liver bed portion of the gallbladder wall, and a full-thickness cholecystectomy for cholecystolithiasis was considered to be useful to decrease the risk of recurrence of occult gallbladder carcinoma.
Waki
M
M
First Department of Surgery, Hamamatsu University School of Medicine, Japan.
D002763:Cholecystectomy / Q000379:methods*; D005706:Gallbladder Neoplasms / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008207:Lymphatic Metastasis; D011379:Prognosis