title: Extensive surgery for carcinoma of the gallbladder.
abstract: BACKGROUND
  The purpose of this study was to clarify the efficacy of, and define the indications for, extensive surgery for gallbladder carcinoma.
  
  
  METHODS
  Between 1979 and 1994, 116 patients with gallbladder carcinoma underwent operation. Radical resection was performed in 80 patients.
  
  
  RESULTS
  In 68 patients with stage III or IV disease, extensive resection including extended right hepatectomy (n = 40), pancreaticoduodenectomy (n = 23) and/or portal vein resection (n = 23) was employed to achieve complete tumour excision. The hospital mortality rate was 18 per cent. The postoperative 3- and 5-year survival rates were 44 and 33 per cent respectively in the patients with stage III disease (n = 9), and 24 and 17 per cent respectively in patients with stage IV (M0) disease (n = 29). In contrast, the postoperative survival rate for the 30 patients with stage IV (M1) disease (7 per cent at 3 years and 3 per cent at 5 years) was worse than that for patients with stage III and stage IV (M0) disease (P = 0.009 and P = 0.062 respectively).
  
  
  CONCLUSIONS
  Radical resection should be undertaken for stage III and stage IV (M0) gallbladder cancer. Although portal vein resection and/or pancreaticoduodenectomy did not contribute to long-term survival, better survival was obtained than that for the unresected patients.
authors.affiliation: First Department of Surgery, Nagoya University School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Kondo
authors.forename: Y
authors.initials: Y
authors.lastname: Nimura
authors.forename: N
authors.initials: N
authors.lastname: Hayakawa
authors.forename: J
authors.initials: J
authors.lastname: Kamiya
authors.forename: M
authors.initials: M
authors.lastname: Nagino
authors.forename: K
authors.initials: K
authors.lastname: Uesaka
mesh_terms: D005706:Gallbladder Neoplasms / Q000601:surgery*; D006498:Hepatectomy / Q000379:methods*; D017052:Hospital Mortality; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000209:etiology / Q000601:surgery; D016577:Pancreaticoduodenectomy / Q000379:methods*; D011169:Portal Vein / Q000601:surgery*; D012086:Reoperation; D016019:Survival Analysis; D016896:Treatment Outcome