Significance of subserosal lesions and results of extended cholecystectomy in the treatment of primary carcinoma of the gallbladder

Thirty-one cases of gallbladder carcinoma, treated by extended cholecystectomy (cholecystectomy plus wedge resection of the liver and lymphadenectomy), were reviewed to analyze the clinicopathological characteristics of the tumor and to define the indications for this procedure. All patients with tumors limited to the mucosa or muscularis, and 83% with non-infiltrative subserosal involvement were alive 5 years following extended cholecystectomy. Those patients with a higher association of papillary or well-differentiated adenocarcinoma and a lower incidence of venous, lymphatic or perineural invasion were thought to have better survival. These patients may have a chance for cure with extended cholecystectomy.