title: [Strategies for the surgical treatment of gallbladder cancer].
abstract: There is controversy in some aspects of the surgical treatment of non-mucosal gallbladder carcinoma. An accurate staging based on T (wall) involvement is crucial, otherwise understanding may yield falsely pessimistic results. The decision about the type of resection to be performed should be based on patient status (age, performance, comorbidities, etc) and tumor characteristics (histological type, vascular, neural or lymphatic spread, cell differentiation, tumor involvement of surgical margins in cystic duct, etc). For muscular (T1b) involvement, there is a great controversy about performing a simple cholecystectomy or en-block radical resection. For T2 there is consensus that an en-block radical surgery including liver resection (IVb - V) and lymphonodal clearance should be performed, since this approach has a great impact in survival. The role of surgical excision for tumors with serosal or liver involvement is controversial, due to the poor survival of these patients. However we have observed a 13% actuarial survival at 5 years, in this subset of patients.
authors.affiliation: Cirugía, Hospital Clínico, Universidad de Chile, Santiago, Chile. fmaluend@ns.hospital.uchile.cl
authors.forename: Fernando
authors.initials: F
authors.lastname: Maluenda
authors.forename: Juan C
authors.initials: JC
authors.lastname: Díaz
authors.forename: Xabier de
authors.initials: Xd
authors.lastname: Aretxabala
authors.forename: Patricio
authors.initials: P
authors.lastname: Burdiles
authors.forename: Attila
authors.initials: A
authors.lastname: Csendes
authors.forename: Luis
authors.initials: L
authors.lastname: Contreras
mesh_terms: D002277:Carcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D002677:Chile / Q000453:epidemiology; D002763:Cholecystectomy / Q000401:mortality; D005260:Female; D005706:Gallbladder Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D006801:Humans; D009367:Neoplasm Staging; D011300:Preoperative Care; D015996:Survival Rate