Extended right hemihepatectomy for gallbladder carcinoma involving the hepatic hilum.
BACKGROUND
Major hemihepatectomy for advanced gallbladder carcinoma remains controversial as it is associated with serious postoperative complications and poor prognosis.


METHODS
All those who underwent extended right hemihepatectomy were identified from a database of patients with gallbladder carcinoma who had surgical resection between 1999 and 2009. The clinicopathological data for these patients were analysed retrospectively.


RESULTS
A total of 126 patients underwent surgical resection, 35 of whom had extended right hemihepatectomy. There were no deaths, but 16 patients had complications. The mean(s.d.) duration of operation and blood loss were 564(206) min and 1472(1268) ml respectively. No blood transfusions were needed in 28 patients. Tumour stage (International Union Against Cancer, sixth edition) was IIA in four, IIB in four, III in 15 and IV in 12 patients. The overall 5-year survival rate was 17 per cent with a median survival of 2·2 years. Three patients survived more than 5 years. The presence of hepatic metastases and gallbladder carcinoma originating from the cystic duct were indicators of poor prognosis.


CONCLUSIONS
Extended right hemihepatectomy for gallbladder cancer is safe and may contribute to long-term survival in selected patients.
Hepatobiliary and Pancreatic Surgery Division, National Cancer Centre Hospital, Tokyo, Japan. kshimada@ncc.go.jp
K
K
Shimada
S
S
Nara
M
M
Esaki
Y
Y
Sakamoto
T
T
Kosuge
N
N
Hiraoka
D000328:Adult; D000368:Aged; D017734:Bile Ducts, Extrahepatic / Q000601:surgery*; D016063:Blood Loss, Surgical / Q000401:mortality; D005260:Female; D005706:Gallbladder Neoplasms / Q000401:mortality / Q000601:surgery*; D006498:Hepatectomy / Q000379:methods* / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000556:secondary; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies