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What is Most appropriate treatment option for the carcinoma gallbladder with invasion of perimuscular connective tissue, diagnosed after laparoscopic cholecystectomy: and explain in detail?
8TH AJCC (2017) TNM classificationT1A - Involvement of lamina propriaT1B - Involvement of muscularis propriaT2A - Invasion of perimuscular connective tissue towards peritoneal side without extension to serosaT2B - Invasion of perimuscular connective tissue towards hepatic side without direct hepatic invasionT3 - Serosal perforation or direct hepatic invasion or involvement of single extrahepatic organT4 - Involvement of poal vein or hepatic aery or two or more extrahepatic organN1 - Metastasis to 1 - 3 lymph nodesN2 - Metastasis to 4 or more lymph nodesM0 - No distant metastasisM1 - Distant metastasis Staging Treatment _______________________________________________________ IA - T1a Lap cholecystectomyIB - T1b_______________________________________________________IIA - T2a IIB - T2b Extended cholecystectomyIIIA - T3IIIB - T1-3 N1____________________________________________________ IVA - T4 N0-1 Extended cholecystectomy + Extended R hepatectomy _______________________________________________________________ IVB - T any N2 Palliation (we give chemotherapy) - T any N any M1 _______________________________________________________________Extended cholecystectomy- Enbloc removal of segment IV b & V of liver + gall bladder + lymph node along* Cystic duct* CBD (peri-choledochal lymph node)* Peripoal* Retro-pancreatic