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Japanese

A Study on Early Cancer of the Gallbladder and the Bile Duct Shingo Nagamitsu 1 1Dept. of Surgery, Faculty of Medicine, Kyushu University pp.1215-1224
Published Date 1970/9/25
DOI https://doi.org/10.11477/mf.1403111310
  • Abstract
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 There is as yet no definition of early cancer of the gallbladder and the bile duct, so we have collected only those cases that had no signs of cancer relapse five years after surgical operation. From 127 institutions in Japan we have been able to gather only 14 cases of cancer of the gallbladder belonging to such category.

 Two of 14 patients of the gallbladder cancer were of advanced cancer, but one of them was alive fifteen years after operation and the other is now healthy after 13 years. Early cancer of the gallbladder appears to be related to older age and longstanding chronic gallbladder diseases. Seven patients were more than 50 years of age. Sex incidence also tend to resemble that found in advanced cancer in that 71 per cent were women. Except 2 advanced cancers, 10 of 12 patients were operated on with unquestionable clinical diagnosis of cholecystitis with or without calculi. Only in 2 of 12 patients were tumors seen as polyps in cholecystograms. Eight of 12 patients were associated with calculi. As for the site of early cancer of the gallbladder, 4 were in the fundus, 4 in the body and 4 in the pouch, all smaller than the thumb-tip. In the pathological findings, nodal involvement was found in 9 of 12 patients, and in 3 was plain or ulcerative. Adenocarcinoma was found in all. In almost all of them it remained in the muscle layer or in situ, not extending into the subserosa. There was no metastasis to lymph node. Cancer of the gallbladder, once the subserosa is infiltrated, shows high tendency to spread to other organs via vascular and lymphatic channels.

 Early cancer of the bile duct was seen in 5 patients. One of them is alive 5 years and another 9 years after surgical operation. One cancer was found in the beginning of the choledochus and the other 4 in the pancreas head. All were adenocarcinomas.


Copyright © 1970, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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