“…N a k a m u r a et al 1 1 a n d Miyazaki et al 1 2 h a v e achieved better survival rates from extensive hepatectomy in cases with direct hepatic invasion than in previously reported cases, in which hepatic wedge resection had been performed. 8 ' 9 According to our study findings, in which the distance between the margin of direct hepatic invasion and hepatic metastasis had no correlation with the extent of direct hepatic invasion, occult localized hepatic metastasis around the gallbladder bed may not be removed by hepatic wedge resection for advanced gallbladder cancer. In view of this possibility, substantial hepatectomy, such as resection of S4a and S5, resection of S4a, S5, and S6, or extended right hepatectomy might be a better choice in cases with direct hepatic invasion but not necessarily in cases with involvement of the hepatoduodenal ligament.…”