Two Types of Extended Liver Resection for Advanced Gallbladder Cancer: How to Do It

Background: Extended liver resection is necessary for advanced gallbladder cancer with hepatic involvement to achieve R0 resection. However, its type or extent and its surgical technique have yet to be established. Methods: To exclude systemic disease, frozen section biopsy following systematic para-aortic lymphadenectomy is recommended before starting extended surgery with curative intent because para-aortic nodes are involved more frequently than expected. Right hepatectomy with biliary reconstruction should be indicated for the hepatic hilum type of advanced gallbladder cancer in which a relatively small tumor in the gallbladder neck infiltrates the hepatic hilum and causes obstructive jaundice. Ventral hepatectomy without biliary reconstruction can be applied for the hepatic bed type in which a large mass in the gallbladder fundus and body penetrates into the hepatic parenchyma through the gallbladder bed. Results: Published online: April 29, 2011 Prof. Satoshi Hirano Department of Surgical Oncology, Division of Surgery Hokkaido University Graduate School of Medicine North-15 West-7, Kita-ku, Sapporo 060-8638 (Japan) Tel. +81 11 706 7714, Fax +81 11 706 7158, E-Mail satto @ med.hokudai.ac.jp © 2011 S. Karger AG, Basel 0253–4886/11/0282–0148$38.00/0 Accessible online at: www.karger.com/dsu D ow nl oa de d by : 54 .7 0. 40 .1 1 11 /2 3/ 20 17 2 :1 7: 46 P M