HEPATOPANCREATODUODENECTOMY FOR SQUAMOUS AND ADENOSQUAMOUS CARCINOMA OF THE GALLBLADDER

The characteristics of squamous or adenosquamous cell carcinoma of the gallbladder differ quite markedly from those of adenocarcinoma, altho ugh the incidence is extremely low. Recently, we encountered both of t he former types of gallbladder carcinoma: a 77-year-old man with squam ous cell carcinoma and a 70-year-old man with adenosquamous cell carci noma of the gallbladder. Both had a large mass in the gallbladder foss a region with infiltration to the liver and invasion of the duodenum. Hepatopancreatoduodenectomy was performed on both of these patients. T he TNM stage of the former was IV (T4NOMO) and of the latter TV (T4NOM O) and of the latter TV (T4N1bMO). The former has remained well withou t recurrence for about 1 year and 4 months after the operation, while the latter died of recurrent disease 6 months after operation. The tru e reason for the difference in the prognosis of these two patients was not known. However, hepatopancreatoduodenectomy is considered to be a most adaptable operative procedure for squamous or adenosquamous cell carcinoma of the gallbladder in view of their mode of spread, and the presence of lymph node metastasis might be a factor of poor prognosis .