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Segment IVa, V Segmentectomy Including the Gallbladder with Resection of the Bile Duct and Lymphadenectomy for Subserosal Cancer of the Gallbladder

  • Seiki Tashiro
  • Hidenori Miyake
Chapter

Abstract

Although innovations have occurred in surgical and diagnostic techniques, the prognosis for advanced gallbladder carcinoma remains poor. Gallbladder cancer invades to the liver easily, either directly or by metastasizing in the gallbladder bed via the venous or lymphatic routes. The gallbladder veins drain into the intrahepatic portal vein, mostly at P4 and P5.1 We have reported that the lymphatic route is also important for hepatic metastasis from the gallbladder, especially metastasis to segments V and IVa.2 Furthermore, we have experienced recurrent tumor in segment V after resection of the gallbladder bed for gallbladder carcinoma with subserosal invasion (ss-cancer). Therefore, we have adopted hepatic segment V and segment IVa subsegmentec-tomy as the standard operative procedure for gallbladder carcinoma with subserosal or direct invasion into the liver extending for 2 cm or less.

Keywords

Bile Duct Inferior Vena Cava Hepatic Duct Gallbladder Carcinoma Middle Hepatic Vein 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

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    Suzuki M, Yamamoto K, Unno M, Katayose Y, Endo K, Oikawa M, Matsuno S (2000) Detection of perfusion areas of the gallbladder vein on computed tomography during arterial portography (CTAP): the background for dual S4a-S5 hepatic subsegmentectomy in advanced gallbladder carcinoma. Hepato-gastroenterology 47:631–635PubMedGoogle Scholar
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    Takagi T, Miyake H, Kurahashi M, Tashiro S (2002) Lymphatic flow into the liver from the gallbladder. J Hepatobiliary Pancreat Surg 9(Suppl 1):82Google Scholar
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    Yamaguchi K, Chijiiwa K, Shimizu S, Yokohata K, Tsuneyoshi M, Tanaka M (1998) Anatomical limit of extended cholecystectomy for gallbladder carcinoma involving the neck of the gallbladder. Int Surg 83:21–23PubMedGoogle Scholar

Copyright information

© Springer Japan 2004

Authors and Affiliations

  • Seiki Tashiro
    • 1
  • Hidenori Miyake
    • 1
  1. 1.The University of Tokushima School of MedicineTokushimaJapan

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