[A case of advanced gallbladder carcinoma of a 77-year-old female successfully resected with extended right hepatic lobectomy with caudate lobectomy and pancreatoduodenectomy].

A 77-year-old woman was admitted with obstructive jaundice. US and CT demonstrated a solid mass 2.5cm in diameter in the hepatic hilum. Cholangiography revealed not only severe stenosis of the hilar hepatic duct but also involvement of the right-posterior-inferior-ventral branch and right caudal branch. Angiography showed almost normal appearance except cystic artery. Duodenal invasion was also detected by per oral duodenography. These findings forced to plan extended right hepatic lobectomy with caudate lobectomy and pancreatoduodenectomy for radicality. In spite of the aged and her complications such as DM, hypertension, scoliosis and bradyacusia, liver function was good and she was mentally very active for life. Therefore, planned operation was performed and the suitability of this operation was proved by histological examination. She underwent resection of the abdominal wall for recurrence 8 months after and now alive without the disease 27 months after the first operation. It is stressed that the most suitable operation should be selected conceiving the mode and severity of cancer extension which is revealed by precise preoperative examinations and extended operation may be indicated in even the elderly if various conditions are good.