Abstract: Objective :To explore whether gallbladder carcinoma invading the muscle layer is a local disease and whether radical second resection is performed after simple cholecystectomy. Methods :A retrospective analysis of 19 patients with gallbladder cancer invading the muscle lay-er, 8 of whom underwent simple cholecystectomy and 11 radical resection with regional lymph node dissection, was performed.A total of 68 regional lymph nodes was examined for metastasis. The median follow-up time was 97 months. Results : No patient had blood vessel invasion on histology.Lymphatic vessel invasion was seen in one patient. The metastases were absent in all lymph nodes examined. Overall 10-year survival was 89per cent. The outcome after simple chole-cystectomy was comparable to that after radical resection. This difference did not have statistical significance. Two patients who underwent radical resection died from tumour relapse. Conclusion :Most early gallbladder carcinoma spread only locally. The patients need not perform radical sec-ond resection when the depth of invasion of gallbladder carcinoma is limited to the muscle layer after simple cholecystectomy.