[Significance of aggressive lymph node dissection in advanced gallbladder carcinoma]

Although aggressive lymph node dissection has been performed in gallbladder carcinoma as well as in other carcinomas of the alimentary tract, there is no definitive evidence of the efficacy of extended lymph node dissection. However, extensive lymph node metastasis is well known in advanced carcinoma of the gallbladder. From the viewpoint of the balance between radicality and safety in surgery, wider lymph node dissection consisting of the lymph nodes in the hepatoduodenal ligamentum and parapancreatic area is recommended in selected patients who hare no involvement of the paraaortic lymph nodes. Complete dissection of the superior mesenteric lymph nodes with pancreaticoduodenectomy is unlikely to result in cure.