@article{oai:u-ryukyu.repo.nii.ac.jp:02016179,
 author = {白石, 祐之 and 野村, 寛徳 and 長濱, 正吉 and 友利, 寛文 and 赤嶺, 珠 and 宜保, 昌樹 and 伊佐, 勉 and 砂川, 亨 and 宮里, 浩 and 与儀, 実津夫 and 武藤, 良弘 and Shiraishi, Masayuki and Nomura, Hironori and Nagahama, Masayoshi and Tomori, Hirofumi and Akamine, Tamaki and Gibo, Masaki and Isa, Tsutomu and Sunagawa, Touru and Miyazato, Hiroshi and Yogi, Mitsuo and Muto, Yoshihiro},
 issue = {4},
 journal = {琉球医学会誌 = Ryukyu Medical Journal},
 note = {Several different procedures for performing a hepatic resection have been used in the surgical treatment of gallbladder carcinoma (GBC), such as a hepatic wedge resection (HWR), a S4a+S5 resection, a right lobectomy, or an extended right lobectomy. In the present study, we tried to compare the differences in the surgical indications between HWR and other larger hepatic resections, regarding to the depth of invasion of GBC. Between January 1996 and September 2000, 12 patients underwent HWR and S4a+S5 resection for GBC, in which the depth of invasion reached the mucosal layer (m) in 1 patient, the muscular layer (mp) in 1, the subserosal (ss) layer in 4, the serosal (se) layer in 3, and the other organ (si) in 3. All 6 patients with m, mp, or ss invasion underwent curative resections, thus resulting in a significantly longer median survival time ($73.0 \pm 71.8$ months after surgery), compared to those 6 patients with either se or si ($7.8 \pm 4.1$ months). In one patient with se (hinflb) invasion, the pathological finding of the invaded hepatic parenchyma showed a rich interstitial segment, which was accompanied by cancerous lymphopathy in the portal tract causing microscopic lymphatic metastasis along with the portal tract. In conclusion, HWR for the GBC patients with mp or ss invasion could be used as the standard surgical procedure, with an excellent survival rate after surgery. GBC patients with hepatic parenchymal invasion, however, should be treated by either a segmental or lobal hepatic resection, in order to control the spread of lymphatic expansion along with the portal trac., 論文},
 pages = {191--195},
 title = {[原著］進行胆嚢癌に対する肝切除術式の選択},
 volume = {20}
}