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Totally Laparoscopic Radical Resection of Gallbladder Cancer: Technical Aspects and Long-Term Results

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Abstract

Introduction

Gallbladder cancer (GBC) is a rare tumor in developed countries. Chile has one of the highest incidences worldwide. For patients affected by resectable T1b or more advanced GBC, radical cholecystectomy (RC) is considered the standard therapy. Our aim is to describe the surgical technique and clinical–pathological results of patients undergoing totally laparoscopic radical resection of GBC.

Methods

Patients undergo laparoscopic radical resection for primary and incidental GBC, between the years 2009 and 2016 in two centers from Chile. Patients in whom suspected bile duct invasion, frozen biopsy did not confirm cancer and para-aortic lymph node sampling was positive were excluded.

Results

Eighteen patients were operated, 77.8% were female with median age of 60.5 year, and 16 patients had previous cholecystectomy with incidental cancer finding. The median operative time was 490 min (400–550). No conversion to open surgery occurred. All patients achieved a R0 resection. Postoperative complications occurred in 2 patients (11.1%), and there was not mortality. After a median follow-up of 59 months, the 5-year survival was 80.7%.

Conclusion

This study shows the technical feasibility of the totally laparoscopic approach for radical resection of GBC with the same principles of classical open surgery. It appears that long-term oncological findings would also be similar at least in less advanced lesions.

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References

  1. Eslick GD (2010) Epidemiology of gallbladder cancer. Gastroenterol Clin North Am  39:307–330

  2. Roa I, Ibacache G, Muñoz S, De Aretxabala X (2014) Gallbladder cancer in Chile: pathologic characteristics of survival and prognostic factors: analysis of 1,366 cases. Am J Clin Pathol 141(5):675–682

    Article  PubMed  Google Scholar 

  3. Hibi T, Cherqui D, Geller DA, Itano O, Kitagawa Y, Wakabayashi G (2014) International survey on technical aspects of laparoscopic liver resection: a web-based study on the global diffusion of laparoscopic liver surgery prior to the 2nd international consensus conference on laparoscopic liver resection in Iwate, Japan. J Hepatobiliary Pancreat Sci 21:737–744

    Article  PubMed  Google Scholar 

  4. Goumard C, Farges O, Laurent A, Cherqui D, Soubrane O, Gayet B et al (2015) An update on laparoscopic liver resection: the French Hepato-Bilio-Pancreatic Surgery Association statement. J Visc Surg 152(2):107–112

    Article  PubMed  CAS  Google Scholar 

  5. Nguyen KT, Gamblin TC, Geller DA (2009) World review of laparoscopic liver resection 2,804 patients. Ann Surg 250(5):831–841

    Article  PubMed  Google Scholar 

  6. Goetze TO, Paolucci V (2014) Die unmittelbare radikale Re-Operation bei inzidentellem T1b-Gallenblasenkarzinom und die Frage der angemessenen Radikalität (CAES-/-CAMIC-Zentralregister: “okkultes Gallenblasenkarzinom”). Zentralbl Chir 139:e43–e48

    Article  PubMed  Google Scholar 

  7. Horiguchi A, Miyakawa S, Ishihara S, Miyazaki M, Ohtsuka M, Shimizu H et al (2013) Gallbladder bed resection or hepatectomy of segments 4a and 5 for pT2 gallbladder carcinoma: Analysis of Japanese registration cases by the study group for biliary surgery of the Japanese Society of Hepato-Biliary-Pancreatic Surgery. J Hepatobiliary Pancreat Sci. 20(5):518–524

    Article  PubMed  Google Scholar 

  8. Kondo S, Nimura Y, Hayakawa N, Kamiya J, Nagino M, Uesaka K (2000) Regional and para-aortic lymphadenectomy in radical surgery for advanced gallbladder carcinoma. Br J Surg 87(4):418–422

    Article  PubMed  CAS  Google Scholar 

  9. Aloia TA, Járufe N, Javle M, Maithel SK, Roa JC, Adsay V et al (2015) Gallbladder cancer: expert consensus statement. HPB (Oxford). 17(8):681–690

    Article  PubMed  PubMed Central  Google Scholar 

  10. Liu G, Li X, Chen Y, Sun H, Zhao G, Hu S (2013) Radical lymph node dissection and assessment: Impact on gallbladder cancer prognosis. World J Gastroenterol 19(31):5150–5158

    Article  PubMed  PubMed Central  Google Scholar 

  11. Goetze TO, Paolucci V (2010) Adequate extent in radical re-resection of incidental gallbladder carcinoma: analysis of the German registry. Surg Endosc 24(9):2156–2164

    Article  PubMed  Google Scholar 

  12. Shirai Y, Sakata J, Wakai T, Ohashi T, Ajioka Y, Hatakeyama K (2012) Assessment of lymph node status in gallbladder cancer: location, number, or ratio of positive nodes. World J Surg Oncol 10(87):87

    Article  PubMed  PubMed Central  Google Scholar 

  13. Agarwal AK, Javed A, Kalayarasan R, Sakhuja P (2015) Minimally invasive versus the conventional open surgical approach of a radical cholecystectomy for gallbladder cancer: a retrospective comparative study. HPB (Oxford) 17(6):536–541

    Article  Google Scholar 

  14. Gumbs AA, Hoffman JP (2010) Laparoscopic completion radical cholecystectomy for T2 gallbladder cancer. Surg Endosc 24(12):3221–3223

    Article  PubMed  Google Scholar 

  15. Gumbs AA, Hoffman JP (2010) Laparoscopic radical cholecystectomy and Roux-en-Y choledochojejunostomy for gallbladder cancer. Surg Endosc 24(7):1766–1768

    Article  PubMed  Google Scholar 

  16. Cho JY, Han H-S, Yoon Y-S, Ahn KS, Kim Y-H, Lee K-H (2010) Laparoscopic approach for suspected early-stage gallbladder carcinoma. Arch Surg 145(2):128–133

    Article  PubMed  Google Scholar 

  17. Gumbs AA, Jarufe N, Gayet B (2013) Minimally invasive approaches to extrapancreatic cholangiocarcinoma. Surg Endosc 27(2):406–414

    Article  PubMed  Google Scholar 

  18. Dindo D, Demartines N, Clavien P-A (2004) Classification of surgical complications. Ann Surg 240(2):205–213

    Article  PubMed  PubMed Central  Google Scholar 

  19. Esterio IR, González PG, Gilda TM, Suárez I, Oróstica JA, Hernández MV et al (2004) Cáncer de la vesícula biliar en colecistectomías por litiasis. Rev Esp Patol 37(3):279–285

    Google Scholar 

  20. Fuks D, Regimbeau J, Pessaux P, Bachellier P, Raventos A, Mantion G et al (2013) Is port-site resection necessary in the surgical management of gallbladder cancer ? J Visc Surg 150(4):277–284

    Article  PubMed  CAS  Google Scholar 

  21. Maker A, Butte J, Oxenberg J, Kuk D, Gonen M, Fong Y et al (2012) Is port site resection necessary in the surgical management of gallbladder cancer? Ann Surg Oncol 19(2):409–417

    Article  PubMed  Google Scholar 

  22. Jin K, Lan H, Zhu T, He K, Teng L (2011) Gallbladder carcinoma incidentally encountered during laparoscopic cholecystectomy: how to deal with it. Clin Transl Oncol 13(1):25–33

    Article  PubMed  Google Scholar 

  23. Misra MC, Guleria S (2006) Management of cancer gallbladder found as a surprise on a resected gallbladder specimen. J Surg Oncol 93(8):690–698

    Article  PubMed  Google Scholar 

  24. Agarwal AK, Kalayarasan R, Javed A, Gupta N, Nag HH (2013) Role of staging laparoscopy in primary gall bladder cancer—an analysis of 409 patients: a prospective study to evaluate the role of staging laparoscopy in the management of gallbladder cancer. Ann Surg 258(2):318–323

    Article  PubMed  Google Scholar 

  25. Palanisamy S, Patel N, Sabnis S, Palanisamy N, Vijay A, Palanivelu P et al (2015) Laparoscopic radical cholecystectomy for suspected early gall bladder carcinoma: thinking beyond convention. Surg Endosc 30(6):2442–2448

    Article  PubMed  Google Scholar 

  26. Shirobe T, Maruyama S (2015) Laparoscopic radical cholecystectomy with lymph node dissection for gallbladder carcinoma. Surg Endosc 29(8):2244–2250

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Digestive Surgery, Hospital Regional de Talca, 1 North #1951, Talca, Chile

    César Muñoz Castro

  2. Medicine School, Universidad Católica del Maule, Talca, Chile

    César Muñoz Castro

  3. Digestive Surgery, Hospital Clinico, Pontificia Universidad Católica de Chile, Santiago, Chile

    Sergio Pacheco Santibañez, Tomás Contreras Rivas & Nicolás Jarufe Cassis

Authors
  1. César Muñoz Castro
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  2. Sergio Pacheco Santibañez
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  3. Tomás Contreras Rivas
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  4. Nicolás Jarufe Cassis
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Correspondence to César Muñoz Castro.

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Castro, C.M., Santibañez, S.P., Rivas, T.C. et al. Totally Laparoscopic Radical Resection of Gallbladder Cancer: Technical Aspects and Long-Term Results. World J Surg 42, 2592–2598 (2018). https://doi.org/10.1007/s00268-018-4490-4

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  • DOI: https://doi.org/10.1007/s00268-018-4490-4

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