SUPERFICIAL ELEVATED-TYPE EARLY GALLBLADDER CARCINOMA TREATED BY LAPAROSCOPIC CHOLECYSTECTOMY

A 60-year-old woman was admitted to our department for detailed examin ation of a polypoid lesion of the gallbladder detected at the time of a mass survey by ultrasound. Endoscopic ultrasonography (EUS) demonstr ated a broad-based mass lesion, about 10 mm in size. with an irregular surface, at the peritoneal side of the body of the gallbladder. The l aver structure of the gallbladder wall had not been destroyed by the m ass. Computed tomography showed no direct invasion of the liver or oth er evidence of metastasis. Type-IIa (superficial elevated-type) early gallbladder cancer was suspected and laparoscopic cholecystectomy was performed. Histologically, the tumor proved to be a papillo-tubular ad enocarcinoma. 9 x 8 mm in size. confined to the mucosa and without lym phatic permeation, vascular involvement. perineural invasion, or other signs of metastasis. Laparoscopic cholecystectomy for gallbladder can cer can be indicated only when a lesion is a pedunculated protruded-ty pe (type-Ip) cancer, or a broad-based cancer 10 mm or less in size loc ated on the peritoneal side with no destruction of the layer structure of the wall demonstrated by EUS. This strategy is justified only with precise evaluation of the lesion by EUS.