Significance of bile duct resection for advanced gallbladder cancer without biliary infiltration

Am J Surg. 2018 Dec;216(6):1122-1126. doi: 10.1016/j.amjsurg.2018.07.014. Epub 2018 Jul 21.

Abstract

Background: Although hepatectomy IVa + V with bile duct resection (BDR) for T2 gallbladder cancer (GBC) is performed in our institution, limited surgery is occasionally selected. This study aimed to clarify the significance of BDR for advanced GBC without biliary infiltration.

Methods: Sixty-seven patients were enrolled who underwent surgery for pT2 or higher GBC without biliary infiltration. The patient disposition, demographics, clinicopathologic factors, disease-free survival (DFS) and overall survival (OS) were compared between the BDR group (n = 33) and non-BDR group (n = 34).

Results: There were no significant differences in TNM factors, R0 rate, morbidity rate and rate of adjuvant chemotherapy between the two groups. The patients in the BDR group were significantly younger, had more lymph nodes harvested than those in the non-BDR group, and more frequently underwent hepatectomy IVa + V and extended lymphadenectomy. There were no significant differences in the OS and DFS rates between the two groups.

Conclusion: The significance of BDR for pT2 or higher advanced GBC without biliary infiltration was equivocal because the patients received no survival benefit by undergoing BDR.

Keywords: Bile duct resection; Biliary infiltration; Gallbladder cancer.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Bile Ducts / pathology*
  • Bile Ducts / surgery*
  • Disease-Free Survival
  • Female
  • Gallbladder Neoplasms / mortality
  • Gallbladder Neoplasms / pathology*
  • Gallbladder Neoplasms / surgery*
  • Hepatectomy
  • Humans
  • Lymph Node Excision
  • Male
  • Middle Aged
  • Neoplasm Invasiveness
  • Survival Rate
  • Treatment Outcome