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Should the extrahepatic bile duct be resected or preserved in R0 radical surgery for advanced gallbladder carcinoma? Results of a Japanese Society of Biliary Surgery Survey: A multicenter study.

Authors :
Tatsuo Araida
Ryouta Higuchi
Mie Hamano
Yoshihito Kodera
Nobuhiro Takeshita
Takehiro Ota
Tatsuya Yoshikawa
Masakazu Yamamoto
Ken Takasaki
Source :
Surgery Today; Sep2009, Vol. 39 Issue 9, p770-779, 10p
Publication Year :
2009

Abstract

Abstract Purpose  We assessed the significance of an extra bile duct resection by comparing the survival of patients with advanced gallbladder carcinoma who had resected bile ducts with those who had preserved bile ducts. A radical cholecystectomy that includes extra bile duct resections has been performed without any clear evidence of whether an extra bile duct resection is preventive or curative. Methods  We conducted a questionnaire survey among clinicians who belonged to the 114 member institutions of the Japanese Society of Biliary Surgery. The questionnaires included questions on the preoperative diagnosis, complications, treatment, and surgical treatment, resection procedures, surgical results, pathological and histological findings, mode and site of recurrence, and the need for additional postoperative treatment. A total of 4243 patients who had gallbladder carcinoma and were treated from January 1, 1994 to December 31, 2003 were identified. The 838 R0 patients with pT2, pT3, and pT4 advanced carcinoma of the gallbladder for which there was no cancer invasion to the hepatoduodenal ligament or cystic duct in the final analysis. Results  The 5-year cumulative survival, postoperative complications, postoperative lymph node metastasis, and local recurrence along the hepatoduodenal ligament were not substantially different between the resected bile duct and the preserved bile duct groups. Conclusions  Our retrospective questionnaire survey showed that an extrahepatic bile duct resection had no preventive value in some patients with advanced gallbladder carcinoma in comparison to similar patients who had no such bile duct resection. An extrahepatic bile duct resection may therefore be unnecessary in advanced gallbladder carcinoma without a direct infiltration of the hepatoduodenal ligament and the cystic duct. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
09411291
Volume :
39
Issue :
9
Database :
Complementary Index
Journal :
Surgery Today
Publication Type :
Academic Journal
Accession number :
44776659
Full Text :
https://doi.org/10.1007/s00595-009-3960-6