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KMID : 0191120140290101333
Journal of Korean Medical Science
2014 Volume.29 No. 10 p.1333 ~ p.1340
Practical Guidelines for the Surgical Treatment of Gallbladder Cancer
Lee Seung-Eun

Kim Kyung-Sik
Kim Wan-Bae
Kim In-Gyu
Nah Yang-Won
Ryu Dong-Hee
Park Joon-Seong
Yoon Myung-Hee
Cho Jai-Young
Hong Tae-Ho
Hwang Dae-Wook
Choi Dong-Wook
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.
KEYWORD
Gallbladder, Neoplasm, General Surgery, Guideline
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