Metastatic Mode and Extended Radical Resection in Advanced Gallbladder Carcinoma_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

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Research Section of Hepatobiliary Surgery, The First Hospital of Xi’an Jiao Tong University, Xi’an 710061， China;

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Keywords：

Advanced gallbladder carcinoma; Metastasis; Extended radical resection/treatment

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ObjectiveTo introduce the current study of the metastatic mode and operation methods in advanced gallbladder carcinoma. MethodsThe literatures about metastatic mode and operation methods of advanced gallbladder carcinoma in recent 5 years were reviewed.ResultsLymph node and hepatic invasion were the main mode of advanced gallbladder carcinoma. The Japanese Society of Biliary Surgery （JSBS） classification to gallbladder carcinoma was more reasonable than the UICC classification. The survival rate after radical resection was higher than that after cholecytectomy in patients with T2n1-2M0. In the patients that tumor extended adjacent organs but the lymph node metastatic localized within n2, extended radical resection provided a survival advantage. If the patients’ tumor was not resectable or who had lymph node metastasis beyond n3, the benefit of extended radical resection seemed limited.ConclusionIn the carefully selected patients, extended radical resection will improve the prognosis of advanced gallbladder carcinoma.

Citation： HAN Yue,SHI Jingsen. Metastatic Mode and Extended Radical Resection in Advanced Gallbladder Carcinoma. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2003, 10(1): 80-82. doi: Copy

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7.	Japanese Society of Biliary Surgery. General Rules for Surgical and Pathological Studies on Cancer of the Biliary Tract [M]. 4th ed. Tokyo: Kanehara，1997∶30-39.
8.	Chijiiwa K, Noshiro H, Nakano K, et al. Role of surgery for gallbladder carcinoma with special reference to lymph node metastasis and stage using western and Japanese classification systems [J].World J Surg, 2000; 24(10)∶1271.
9.	Ohtsuka M, Miyazaki M, Itoh H, et al. Routes of hepatic metastasis of gallbladder carcinoma [J]. Am J Clin Pathol, 1998; 109(1)∶ 62.
10.	Lundberg O,Kristoffersson A.Wound recurrence from gallbladder cancer after open cholecystectomy [J].Surgery, 2000； 127(3)∶296.
11.	Lundberg O,Kristoffersson A. Effective of pneumoperitoneum induced by carbon dioxide and air on tumor load in a rat model [J]. World J Surg, 1998; 22(5)∶470.
12.	Aoki Y,Shimura H,Li H,et al. A model of portsite metastases of gallbladder cancer: the influence of peritoneal injury and its repair on abdominal wall metastases [J]. Surgery, 1999; 125(5)∶553.
13.	Chijiiwa K, Nakano K, Ueda J, et al. Surgical treatment of patients with T2 gallbladder carcinoma invading the subserosal layer [J].J Am Coll Surg, 2001; 192(5)∶600.
14.	Shirai Y, Tsukada K, Ohtani T, et al. Hepatic metastases from carcinoma of the gallbladder [J].Cancer, 1995; 75(8)∶2063.
15.	Shirai Y,Ohtani T,Tsukada K,et al.Combined pancreaticoduodenectomy and hepatectomy for patients with locally advanced gallbladder carcinoma: long term results [J].Cancer, 1997; 80(10)∶1904.
16.	彭淑牖,彭承宏,牟一平, 等. 胆囊癌的扩大根治术 [J].世界华人消化杂志, 2000; 8(特8)∶75.
17.	Todoroki T,Kawamoto T,Takashi H,et al.Treatment of gallbladder cancer by radical resection [J].Br J Surg,1999; 86(5)∶622.

1. Donohue J, Stewart A, Menck HR. The National Cancer Data Base report on carcinoma of the gallbladder, 19891995 [J]. Cancer, 1998; 83(12)∶ 2618.
2. 石景森. 原发性胆囊癌的发病与诊治进展 [J]. 中国普外基础与临床杂志, 2002; 9 (2)∶70.
3. Tsukada K, Kurosaki I, Uchida K, et al. Lymph node spread from carcinoma of the gallbladdr [J]. Cancer, 1997; 80(4)∶661.
4. Gebbia V, Majello E, Testa A, et al. Treatment of advanced adenocarcinomas of the exocrine pancreas and the gallbladder with 5fluorouracil, high dose levofolinic acid and oral hydroxyurea on a weekly schedule.Results of a multicenter study of the Southern Italy Oncology Group (G.O.I.M.) [J].Cancer, 1996; 78(6)∶1300.
5. Kondo S, Nimura Y, Hayakawa N, et al. Regional and paraaortic lymphadenectomy in radical surgery for advanced gallbladder carcinoma [J]. Br J Surg, 2000; 87(4)∶418.
6. Uesaka K, Yasui K, Morimoto T, et al. Visualization of routes of lymphatic drainage of the gallbladder with a carbon particle suspension [J].J Am Coll Surg, 1996; 183(4)∶345.
7. Japanese Society of Biliary Surgery. General Rules for Surgical and Pathological Studies on Cancer of the Biliary Tract [M]. 4th ed. Tokyo: Kanehara，1997∶30-39.
8. Chijiiwa K, Noshiro H, Nakano K, et al. Role of surgery for gallbladder carcinoma with special reference to lymph node metastasis and stage using western and Japanese classification systems [J].World J Surg, 2000; 24(10)∶1271.
9. Ohtsuka M, Miyazaki M, Itoh H, et al. Routes of hepatic metastasis of gallbladder carcinoma [J]. Am J Clin Pathol, 1998; 109(1)∶ 62.
10. Lundberg O,Kristoffersson A.Wound recurrence from gallbladder cancer after open cholecystectomy [J].Surgery, 2000； 127(3)∶296.
11. Lundberg O,Kristoffersson A. Effective of pneumoperitoneum induced by carbon dioxide and air on tumor load in a rat model [J]. World J Surg, 1998; 22(5)∶470.
12. Aoki Y,Shimura H,Li H,et al. A model of portsite metastases of gallbladder cancer: the influence of peritoneal injury and its repair on abdominal wall metastases [J]. Surgery, 1999; 125(5)∶553.
13. Chijiiwa K, Nakano K, Ueda J, et al. Surgical treatment of patients with T2 gallbladder carcinoma invading the subserosal layer [J].J Am Coll Surg, 2001; 192(5)∶600.
14. Shirai Y, Tsukada K, Ohtani T, et al. Hepatic metastases from carcinoma of the gallbladder [J].Cancer, 1995; 75(8)∶2063.
15. Shirai Y,Ohtani T,Tsukada K,et al.Combined pancreaticoduodenectomy and hepatectomy for patients with locally advanced gallbladder carcinoma: long term results [J].Cancer, 1997; 80(10)∶1904.
16. 彭淑牖,彭承宏,牟一平, 等. 胆囊癌的扩大根治术 [J].世界华人消化杂志, 2000; 8(特8)∶75.
17. Todoroki T,Kawamoto T,Takashi H,et al.Treatment of gallbladder cancer by radical resection [J].Br J Surg,1999; 86(5)∶622.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Metastatic Mode and Extended Radical Resection in Advanced Gallbladder Carcinoma

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