Exokrines Pankreas

Remmele, W.

doi:10.1007/978-3-642-69454-7_12

Cited by 1 publication

(6 citation statements)

References 288 publications

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“…5, 6). Continuous spread into the liver is found in 65%-95% of cases at the time of operation or at autopsy (2,11). In our own series, the rate of direct invasion of the liver was 59%.…”

Section: Spread Of Gallbladder Carcinomamentioning

confidence: 57%

“…Direct invasion of tumor into the adjacent segments IVb, V, and, perhaps, VI, of the liver is most common. Direct infiltration of the adjacent liver segments is found in 65%-95% according to the literature [2,11,12]. The nodes on the cystic duct, and those of the bile duct and in the hilus of the liver are considered the first level of regional lymph nodes of the gallbladder.…”

Section: Discussionmentioning

confidence: 99%

“…The second lymph node level of the gallbladder are the lymph nodes around the pancreatic head, the duodenum, the periportal, the celiac, and the superior mesenteric nodes. Invasion of the regional lymph nodes in gallbladder carcinoma is found in 45%--80% of cases [2,11,12].…”

Section: Discussionmentioning

confidence: 99%

“…In advanced tumor stages, infiltration or compression of the bile duct leading to jaundice can occur if the lymph nodes are infiltrated. Based on the literature, about 45%--80% of patients with gallb}adder carcinoma had lymph node metastases at the time of operation or at autopsy [2,11,12].…”

Section: Spread Of Gallbladder Carcinomamentioning

confidence: 99%

“…These anatomic findings confirm reports in the literature of multiple metastases in the right hepatic lobe in gallbladder carcinoma. A breach of gallbladder carcinoma into the gallbladder vein has been described in only 0%--10% of cases [9,11]. Papillary and undifferentiated carcinomas spread occasionally by intraductal means into the efferent biliary tracts; rates of 4% of all gallbladder carcinomas and 19% of papillary carcinomas have been reported [11], Fig.…”

Section: Spread Of Gallbladder Carcinomamentioning

confidence: 99%

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Radical operations for carcinoma of the gallbladder: Present status in Germany

et al. 1991

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Despite the overall poor prognosis of gallbladder carcinoma, it appears that, in resectable lesions, an aggressive surgical approach promises improvement in survival rates. Radical treatment of gallbladder carcinoma is based on a detailed knowledge of the lymphatic, venous, direct, and intraductal modes of spread of gallbladder carcinoma. Customized therapy of gallbladder carcinoma takes staging into consideration: if one is dealing with gallbladder carcinoma with macroscopic liver infiltration (T3 or T4), or with a pre- or intraoperatively diagnosed gallbladder carcinoma with an unknown depth of infiltration, an en bloc resection of the gallbladder with adjacent liver segments IVb and V, perhaps including IV, as well as a dissection of the hepatoduodenal ligament should be performed. If the carcinoma is missed intraoperatively at the time of cholecystectomy for other indications, in the presence of a T2 gallbladder carcinoma in proximity to the liver bed, reoperation with dissection of the hepatoduodenal ligament and resection of liver segments IVb and V should be performed. In the presence of T1 gallbladder carcinoma, simple cholecystectomy is adequate. This concept is based on our experience with 113 patients with gallbladder carcinoma who underwent treatment in our department from January, 1970 to June, 1989. Sixty-seven percent of the gallbladder carcinomas were resected, 30% for cure and 37% palliatively. In 33%, the operation was limited to an exploratory laparotomy or a palliative operation, or no operation was performed. Of the curatively resected carcinomas (n = 34), 7 were Stage I, 7 Stage II, 9 Stage III, and 11 Stage IV.(ABSTRACT TRUNCATED AT 250 WORDS)

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“…5, 6). Continuous spread into the liver is found in 65%-95% of cases at the time of operation or at autopsy (2,11). In our own series, the rate of direct invasion of the liver was 59%.…”

Section: Spread Of Gallbladder Carcinomamentioning

confidence: 57%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Spread Of Gallbladder Carcinomamentioning

confidence: 99%