J Korean Med Sci.  2014 Oct;29(10):1333-1340. 10.3346/jkms.2014.29.10.1333.

Practical Guidelines for the Surgical Treatment of Gallbladder Cancer

• Lee SE
• Kim KS
• Kim WB
• Kim IG
• Nah YW
• Ryu DH
• Park JS
• Yoon MH
• Cho JY
• Hong TH
• Hwang DW
• Choi DW
• Korean Association of Hepato-Biliary and Pancreas Surgery

• KMID: 2129622
• DOI: http://doi.org/10.3346/jkms.2014.29.10.1333

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

MeSH Terms

Cholecystectomy, Laparoscopic/*methods
Gallbladder Neoplasms/epidemiology/mortality/*surgery
Humans
Incidental Findings
Laparotomy
Liver Neoplasms/secondary/*surgery
Lymph Node Excision/*methods
Lymph Nodes/pathology/surgery
Lymphatic Metastasis/*pathology
Survival Rate

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