Median survival was 182 days. Percutaneous self-expandable metallic stents are an efficient means treating malignant biliary strictures, particularly of upper biliary obstructions. I. Most of the patients in stage III-IV cancer died within one year whereas most of the stage I cancer patients survived more than two years. Simple cholecystectomy is strongly advised in women above 50 years of age and in men above 60 years of age with symptomatic cholelithiasis. I, Kyushu University Faculty of Medicine, Fukuoka, Japan.
Extended cholecystectomy is the common operation for gallbladder carcinoma.
There have been few reports providing convincing data with regard to how thick the liver can be anatomically resected by extended cholecystectomy. The thickness of the liver tissue actually resected at the time of extended cholecystectomy and that potentially resected by extended cholecystectomy were measured in 24 clinical and 25 autopsy cases, respectively, to assess the anatomical limit of extended cholecystectomy. The mean anatomical distances from the neck of the gallbladder to the right hepatic duct and to the bifurcation of the anterior and posterior branch of the right hepatic duct were only 1.6 and 5.9 mm, respectively. The actual width of the liver excised by extended cholecystectomy was 5.2 mm at the neck, 11.7 mm at the body, and 8.1 mm at the fundus of the gallbladder, respectively. These results indicate that the neck of the gallbladder is anatomically close to the hepatic hilum including the right hepatic duct and portal vein.