Surgical procedures in gallbladder cancer with special reference to its macroscopic appearance

To investigate the relationships of the gross appearance to cancer depth and microinvasion in gallbladder cancer, thirty-three cancers were macroscopically subgrouped: papillary (n=8), nodular (n=6), papillo-invasive (n=1), nodulo-invasive (n=11), and invasive (n=7) type, respectively. Papillary type cancers were limited to the mucosa or the muscularis propria, without microinvasion. Most nodular type cancers infiltrated to the subserosa with moderate microinvasion. The other types of cancer frequently invaded the subserosa or more, with high incidence of microinvasion. Only the papillary type cancers indicated simple cholecystectomy, the other types should be operated in accordance with infiltration depth and degree of involvement.