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Hepatectomy of segment 4b and 5 with extrahepatic bile duct resection for pT2 gallbladder carcinoma is valid: a single-institution result

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Abstract

The results of surgical treatment for T2 gallbladder carcinoma are equivocal, while the precise preoperative TNM staging and localization of gallbladder carcinoma are difficult. The aim of this study was to report the validity of segment 4b and 5 (S4b+5) hepatectomy with extrahepatic bile duct resection for these tumors. We reviewed 30 patients with pT2 gallbladder cancer who underwent S4b+5 hepatectomy with extrahepatic bile duct resection. The median number of lymph nodes retrieved in the S4b+5 hepatectomy group was 11 (0–23) nodes, and lymph node metastasis was observed in 9 of 30 (30 %) cases. Although all surgical margins were macroscopically negative, 4 of the 30 patients (13 %) had pathologically positive margins. The overall survival rate of patients was 85.1 % at 5 years. Of the 30 patients with S4b+5 hepatectomy, surgical margin alone was analyzed as a prognostic factor in univariate and multivariate analysis. The survival rate was comparable between the tumor on the hepatic side and peritoneal side (P = 0.856). Nine patients with additional S4b+5 hepatectomy after simple cholecystectomy because of incidental diagnosis of gallbladder cancer also had comparable survival compared to the remaining 21 patients with simultaneous S4b+5 hepatectomy (P = 0.624). S4b+5 hepatectomy with extrahepatic bile duct resection could be good treatment modality for T2 gallbladder cancers because precise preoperative diagnosis of tumor depth, location, and lymph node metastasis for these tumors is difficult.

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Authors and Affiliations

  1. Department of Surgery, Ogaki Municipal Hospital, 4-86 Minaminokawa-cho, Ogaki, Gifu, 503-8502, Japan

    Shunsuke Onoe, Yuji Kaneoka, Atsuyuki Maeda, Yuichi Takayama, Yasuyuki Fukami & Masatoshi Isogai

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  1. Shunsuke Onoe
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  2. Yuji Kaneoka
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  3. Atsuyuki Maeda
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  4. Yuichi Takayama
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  5. Yasuyuki Fukami
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  6. Masatoshi Isogai
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Correspondence to Shunsuke Onoe.

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We declare that in the study were respected the ethical standards conformed to the guidelines of the Helsinki Declaration. No study advertising was made and no remuneration was offered.

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This article does not contain any studies with animals performed by any of the authors.

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Informed consent was obtained from all individual participants included in the study.

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Onoe, S., Kaneoka, Y., Maeda, A. et al. Hepatectomy of segment 4b and 5 with extrahepatic bile duct resection for pT2 gallbladder carcinoma is valid: a single-institution result. Updates Surg 67, 265–271 (2015). https://doi.org/10.1007/s13304-015-0319-y

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  • DOI: https://doi.org/10.1007/s13304-015-0319-y

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