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Curative resection in potentially resectable tumours of the gallbladder
X A de Aretxabala1, I S Roa, L A Burgos
1Department of Surgery, Universidad de la Frontera, Temuco, Chile.
Objective:
To study the value of surgical treatment in patients with potentially resectable gallbladder cancer.
Design:
Prospective non-randomised study.
Setting:
University hospital, Chile.
Subjects:
109 Patients with gallbladder cancers, most of which were detected in the cholecystectomy specimen.
Interventions:
53 Patients underwent reoperation with the aim of doing a lymphadenectomy and resecting the gallbladder bed.
Main Outcome Measures:
Morbidity and short and long term mortality
Results:
Residual tumour after cholecystectomy was mainly observed in patients with serosal and adipose tissue infiltration. Lymph nodes and liver invasion were associated with recurrence. Survival analysis was focused on the group with subserosal infiltration because it is the largest subgroup in this study and prognosis is intermediate. Patients who underwent curative resection had a significantly better survival than those treated by simple cholecystectomy (p = 0.005).
Conclusions:
Extended cholecystectomy improved the prognosis of patients whose cancers were restricted to the subserosal layer. Additional treatments are necessary to improve the results obtained with operation alone.