Surgical treatment of gallbladder cancer

Surgical resection is the first choice for gallbladder cancer. Neither chemotherapy nor radiotherapy is effective. The surgical method is selected according to the extent of the lesion.

(1) Simple cholecystectomy is suitable for Nevin stage I and UICCI lesions. These lesions are usually stage VI gallstones and cholecystitis. After cholecystectomy, pathological examination reveals gallbladder cancer. If it is confined to the gallbladder mucosa, no further surgery is necessary. If the pathological examination shows that the resection margin is positive for the serosa, another surgery should be performed to remove the serosa and clear the local lymph nodes.

(2) Radical resection of gallbladder cancer is applicable to Nevin stage II, III, IV and UICC stage II lesions. In addition to the gallbladder, the resection scope also includes wedge resection of the liver 2 cm away from the gallbladder bed and lymph node dissection in the gallbladder drainage area, but resection of segment IVb (quadratic lobe) and segment V of the liver is more reasonable and consistent with the anatomy.

(3) Extended radical resection of gallbladder cancer: For Nevin stage III and IV and UICC stage III and IVA lesions, there are more and more reports of successful surgical treatment both at home and abroad. In addition to radical resection, the scope of resection also includes right hemiliver or right trisegment liver resection, pancreaticoduodenectomy, and hepatic artery or (and) portal vein reconstruction, but the surgery is very traumatic.