Abstract
Background
Laparoscopic cholecystectomy (LC) for gallbladder carcinoma still is controversial except for the early stages of gallbladder carcinoma (Tis). This study was designed to evaluate and revisit the role of LC in treating gallbladder carcinoma.
Methods
Available medical records of patients with surgeries for gallbladder carcinoma were retrospectively investigated from August 1992 to February 2005.
Results
Among 219 patients treated for gallbladder carcinoma, 57 (26%) underwent LC. A total of 16 patients (28.1%) underwent subsequent radical cholecystectomy (LC–RC), and 41 (71.9%) were only followed up without radical surgery (LC). Tis was found in 11 patients (19.3%), T1a in 3 patients (5.3%), T1b in 8 patients (14%), T2 in 19 patients (33.3%), and T3 in 16 patients (28.1%). The findings showed R0 in 14 cases of the radical cholecystectomy group, and clinical R0 was noted in 30 cases of the LC-only group. No survival differences were noted between LC and LC–RC (p = 0.2575), especially in the case of T2 lesions (p = 0.6274), nor between the R0 and clinical R0 (p = 0.5839). However, significant survival differences were noted between the R2 and R0 groups, and between R2 and clinical R0, respectively (p < 0.001).
Conclusions
The findings show that LC could be appropriate treatment for gallbladder carcinoma only in selected cases of clinical R0 lesions.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Baer HU, Metzger A, Glattli A, Klaiber C, Ruchti C, Czerniak A (1995) Subclinical periumblical metastasis of a gallbladder carcinoma after laparoscopic cholecystectomy. Surg Laparosc Endosc 5: 59
Brasesco OE, Rosin D, Rosenthal RJ (2002) Laparoscopic surgery of the liver and biliary tract. J Laparoendosc Adv Surg Tech A.12: 91–100
Edwin B, Mala T, Mathisen O, Gladhauq I, Buanes T, Lunde OC, Soreide O, Berqan A, Fosse E (2004) Laparoscopic resection of the pancreas: a feasibility study of the short-term outcome. Surg Endosc 18: 361–362
Fong Y, Jarnagin W, Blumgart LH (2000) Gallbladder cancer: comparison of patients presenting initially for definitive operation with those presenting after prior noncurative intervention. Ann Surg 232: 557–567
Frederick LG, David LP, Irvin DF, April F, Charles MB, Daniel GH, Monica M (2002) AJCC Cancer staging manual. 6th ed. Lippincott-Raven, Philadelphia
Kang CM, Lee JG, Kim KS, Choi JS, Lee WJ, Kim BR (2006) What we learned from the experience of laparoscopic splenectomy in patients with idiopathic thrombocytopenic purpura (ITP): single surgeon experiences. Surg Laparosc Endosc Percutan Tech 16: 151–155
Koo KP, Richard C, Thirlby RC (1996) Laparoscopic cholecystecotmy in acute cholecystitis. Arch Surg 131: 540–545
Lazcano-Ponce EC, Miquel JF, Munoz N, Herrero R, Ferrecio C, Wistuba II, Alonso de Ruiz P, Aristi Urista G, Nervi F (2001) Epidemiology and molecular pathology of gallbladder cancer. CA Cancer J Clin 51: 349–364
Tan M, Kandaswamy R, Sutherland DE, Gruessner RW (2005) Laparoscopic donor distal pancreatectomy for living donor pancreas and pancreas–kidney transplantation. Am J Transplant 5: 1966–1970
Misra S, Chaturvedi A, Misra C, Sharma ID (2003) Carcinoma of the gallbladder. Lancet Oncol 4: 167–176
Pack GT, Miller TR, Brasfield RD (1955) Total right hepatectomy for cancer of the gallbladder. Ann Surg 142: 6–16
Pearlstone DB, Feig BW, Mansfield PF (1999) Port-site recurrences after laparoscopy for malignant disease. Semin Surg Oncol 16: 307–312
Sakuramoto S, Kikuchi S, Kuroyama S, Futawatari N, Katada N, Kobayashi N, Watanabe M (2005) Laparoscopy-assisted distal gastrectomy for early gastric cancer: experience with 111 consecutive patients. Surg Endosc 20: 55–60
Sandor J, Ihasz M, Fazekas T, Regoly-Merei J, Batorfi J (1995) Unexpected gallbladder cancer and laparoscopic surgery. Surg Endos 9: 1207
Stolzenburg JU, Rabenalt R, DO M, Ho K, Dorschner W, Waldkirch E, Jonas U, Schutz A, Hom L, Truss MC (2005) Endoscopic extraperitoneal radical prostatectomy: oncological and functional results after 700 procedures. J Urol 174: 1271–1275, discussion 1275
Sun CD, Zhang BY, Wu LQ, Lee WJ (2005) Laparoscopic cholecystectomy for treatment of unexpected early-stage gallbladder cancer. J Surg Oncol 91: 252–257
Suzuki S, Yokoi Y, Kurachi K, Inaba K, Ota S, Azuma M, Konno H, Baba S, Nakamura S (2004) Appraisal of surgical treatment for pT2 gallbladder carcinoma. World J Surg 28: 160–165
Tsunoda T, Tsuchiya R, Harada N, Izawa K, Yamaguchi T, Yamamoto K, Motoshima K, Tomioka T, Matsuo S, Eto T (1987) The surgical treatment for carcinoma of the gallbladder. Jpn J Surg 17: 478–486
Wade TP, Comitalo JB, Andrus CH, Goodwin MN, Kaminski DL (1994) Laparoscopic cancer surgery. Surg Endos 8: 698
Wakai T, Shirai Y, Yokoyama N, Nagakura S, Watanabe H, Hatakeyama K (2001) Early gallbladder carcinoma does not warrant radical resection. Br J Surg 88: 675–678
Weiland ST, Mahvi DM, Niederhuber JE, Heisey DM, Chicks DS, Rikkers LF (2002) Should suspected early gallbladder cancer be treated laparoscopically? J Gastrointest Surg 6: 50–56, discussion 56–57
Zmora O, Gervaz P, Wexner SD (2001) Trocar-site recurrence in laparoscopic surgery for colorectal cancer. Surg Endosc 15: 788–793
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kang, C.M., Choi, G.H., Park, S.H. et al. Laparoscopic cholecystectomy only could be an appropriate treatment for selected clinical R0 gallbladder carcinoma. Surg Endosc 21, 1582–1587 (2007). https://doi.org/10.1007/s00464-006-9133-4
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00464-006-9133-4