ABSTRACT
Purpose: The surgical management of gallbladder cancer discovered after cholecystectomy is controversial. There is no consensus as to the indication for reoperation or radical resection. The aim of this study was to review the results of reoperation and results of extended resection of theses patients
Methods: fifty three patients were referred to our center with pathological diagnosis of cancer after cholecystectomy. Ten other cases were added with a clinical diagnosis of gall bladder cancer and had their primary treatment in our side. Of the total 63 cases 17 [27%] cases underwent extended resection while the others had residual disease far extensive for resection. Extended resection included partial resection of segment IV and V together with nodal dissection of the hepatoduodenal ligament. Two cases had extended right hepatectomy
Results: The mean survival period for cases with extended resection was 28.7 months while for simple cholecystectomy it was 11.2 months. Two years and 5-years survival rates were 52.9% and 11.7% respectively for extended resection patients while, for cases treated by simple cholecystectomy alone they were 21.7% and 6.2% respectively. Extended resection had better results for T2 cases than T3 cases and cases with nodal involvement had poor results in comparison to node negative cases
Conclusion: Simple cholecystectomy alone is not enough for gallbladder cancer with deep invasion more than T1. Second surgery should be restricted for cases without nodal involvement and for T2 more than T3 cases provided there is no other sign of dissemination