title: Practical guidelines for the surgical treatment of gallbladder cancer.
abstract: At present, surgical treatment is the only curative option for gallbladder (GB) cancer. Many efforts therefore have been made to improve resectability and the survival rate. However, GB cancer has a low incidence, and no randomized, controlled trials have been conducted to establish the optimal treatment modalities. The present guidelines include recent recommendations based on current understanding and highlight controversial issues that require further research. For T1a GB cancer, the optimal treatment modality is simple cholecystectomy, which can be carried out as either a laparotomy or a laparoscopic surgery. For T1b GB cancer, either simple or an extended cholecystectomy is appropriate. An extended cholecystectomy is generally recommended for patients with GB cancer at stage T2 or above. In extended cholecystectomy, a wedge resection of the GB bed or a segmentectomy IVb/V can be performed and the optimal extent of lymph node dissection should include the cystic duct lymph node, the common bile duct lymph node, the lymph nodes around the hepatoduodenal ligament (the hepatic artery and portal vein lymph nodes), and the posterior superior pancreaticoduodenal lymph node. Depending on patient status and disease severity, surgeons may decide to perform palliative surgeries.
authors.affiliation: Department of Surgery, Chung-Ang University College of Medicine, Seoul, Korea.
authors.forename: Seung Eun
authors.identifier: 0000-0003-1830-9666
authors.initials: SE
authors.lastname: Lee
authors.affiliation: Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Kyung Sik
authors.identifier: 0000-0001-9498-284X
authors.initials: KS
authors.lastname: Kim
authors.affiliation: Department of Surgery, Korea University College of Medicine, Seoul, Korea.
authors.forename: Wan Bae
authors.identifier: 0000-0001-6545-3105
authors.initials: WB
authors.lastname: Kim
authors.affiliation: Department of Surgery, Hallym University College of Medicine, Chuncheon, Korea.
authors.forename: In-Gyu
authors.identifier: 0000-0002-0751-4288
authors.initials: IG
authors.lastname: Kim
authors.affiliation: Department of Surgery, University of Ulsan College of Medicine, Ulsan, Korea.
authors.forename: Yang Won
authors.identifier: 0000-0001-8161-9849
authors.initials: YW
authors.lastname: Nah
authors.affiliation: Department of Surgery, Chungbuk National University College of Medicine and Medical Research Institute, Cheongju, Korea.
authors.forename: Dong Hee
authors.identifier: 0000-0001-6088-298X
authors.initials: DH
authors.lastname: Ryu
authors.affiliation: Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Joon Seong
authors.identifier: 0000-0001-8048-9990
authors.initials: JS
authors.lastname: Park
authors.affiliation: Department of Surgery, Kosin University College of Medicine, Busan, Korea.
authors.forename: Myung Hee
authors.identifier: 0000-0001-9271-7241
authors.initials: MH
authors.lastname: Yoon
authors.affiliation: Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Jai Young
authors.identifier: 0000-0002-1376-956X
authors.initials: JY
authors.lastname: Cho
authors.affiliation: Department of Surgery, Catholic University College of Medicine, Seoul, Korea.
authors.forename: Tae Ho
authors.identifier: 0000-0003-3864-8104
authors.initials: TH
authors.lastname: Hong
authors.affiliation: Department of Surgery, University of Ulsan College of Medicine, Ulsan, Korea.
authors.forename: Dae Wook
authors.identifier: 0000-0002-1749-038X
authors.initials: DW
authors.lastname: Hwang
authors.affiliation: Department of Surgery, Sungkyunkwan University College of Medicine, Seoul, Korea.
authors.forename: Dong Wook
authors.identifier: 0000-0022-0751-7841
authors.initials: DW
authors.lastname: Choi
mesh_terms: D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D005706:Gallbladder Neoplasms / Q000453:epidemiology / Q000401:mortality / Q000601:surgery*; D006801:Humans; D033162:Incidental Findings; D007813:Laparotomy; D008113:Liver Neoplasms / Q000556:secondary / Q000601:surgery*; D008197:Lymph Node Excision / Q000379:methods*; D008198:Lymph Nodes / Q000473:pathology / Q000601:surgery; D008207:Lymphatic Metastasis / Q000473:pathology*; D015996:Survival Rate
keywords: Gallbladder; General Surgery; Guideline; Neoplasm