Surgical Endoscopy

, Volume 29, Issue 8, pp 2244–2250 | Cite as

Laparoscopic radical cholecystectomy with lymph node dissection for gallbladder carcinoma

  • Takashi Shirobe
  • Shotaro Maruyama



Laparoscopic surgery has been widely employed in the field of digestive surgery, since the minimally invasive procedure provides a significant benefit to patients. However, laparoscopic curative surgery for gallbladder cancer has been rarely described. The aim of this study was to evaluate the effectiveness and validity of laparoscopic radical cholecystectomy with lymph node dissection (Lap-RC) to treat with T1b/T2 gallbladder carcinoma.


A total of 11 patients underwent Lap-RC for gallbladder carcinoma from November 2001 until June 2013. While 4 patients were preoperatively diagnosed with T1b/T2 gallbladder carcinoma, 7 patients were diagnosed with incidental T1b/T2 gallbladder carcinoma by postoperative pathological examination after laparoscopic cholecystectomy. Common bile duct resection and biliary tract reconstruction were performed in 2 cases. End points in this clinical study were tumor recurrence and survival of patients.


Mean operative time was 196 min, and average hospital stay after surgery was 6.4 days, excluding 2 cases with biliary tract reconstruction. One patient died of recurrence of cancer 89 months after surgery, and another patient died of other reason with local recurrence 39 months after the operation. The other 9 patients were all alive without recurrence at this writing. The 5-year survival rate was 100 % for T1b patients and 83.3 % for T2. These results indicate that almost equivalent outcomes compared with open surgery in terms of curability were achieved.


We conclude that pure laparoscopic radical cholecystectomy with lymph node dissection is safe and beneficial for the patients with T1b/T2 gallbladder carcinoma.


Laparoscopic radical cholecystectomy Gallbladder carcinoma Lymph node dissection 



The authors would like to give special thanks Dr. Tomoki Yokochi at Chiba Tokushukai Hospital for his guidance in the preparation of this manuscript. This paper is dedicated to the memory of Dr. Tatsuro Imai as a token of our gratitude. The authors have no conflicts of interest to disclose. There is no financial support for this study. This advanced therapeutic protocol was registered at UMIN-CTR (UMINID: UMIN000013841).


Drs. Takashi Shirobe and Shotaro Maruyama have no conflicts of interest or financial ties to disclose.


  1. 1.
    Morise Z, Sugioka A, Kawabe N, Umemoto S, Nagata H, Ohshima H, Kawase J, Arakawa S, Yoshida R (2011) Pure laparoscopic hepatectomy for hepatocellular carcinoma patients with severe liver cirrhosis. Asian J Endosc Surg 4:143–146PubMedCrossRefGoogle Scholar
  2. 2.
    Lai EC, Tang CN (2013) Current status of robot-assisted laparoscopic pancreaticoduodenectomy and distal pancreatectomy: a comprehensive review. Asian J Endosc Surg 6:158–164PubMedCrossRefGoogle Scholar
  3. 3.
    Gumbs AA, Hoffman JP (2010) Laparoscopic radical cholecystectomy and Roux-en-Y choledochojejunostomy for gallbladder cancer. Surg Endosc 24:1766–1768PubMedCrossRefGoogle Scholar
  4. 4.
    Hu JB, Sun XN, Xu J, He C (2008) Port site and distant metastases of gallbladder cancer after laparoscopic cholecystectomy diagnosed by positron emission tomography. World J Gastroenterol 14:6428–6431PubMedCentralPubMedCrossRefGoogle Scholar
  5. 5.
    Lee JM, Kim BW, Kim WH, Wang HJ, Kim MW (2011) Clinical implication of bile spillage in patients undergoing laparoscopic cholecystectomy for gallbladder cancer. Am Surg 77:697–701PubMedGoogle Scholar
  6. 6.
    Yamamoto H, Hayakawa N, Kitagawa Y, Katohno Y, Sasaya T, Takara D, Nagino M, Nimura Y (2005) Unsuspected gallbladder carcinoma after laparoscopic cholecystectomy. J Hepatobiliary Pancreat Surg 12:391–398PubMedCrossRefGoogle Scholar
  7. 7.
    Shirai Y, Wakai T, Sakata J, Hatakeyama K (2012) Regional lymphadenectomy for gallbladder cancer: rational extent, technical details, and patient outcomes. World J Gastroenterol 18:2775–2783PubMedCentralPubMedCrossRefGoogle Scholar
  8. 8.
    Koshenkov VP, Koru-Sengul T, Franceschi D, Dipasco PJ, Rodgers SE (2013) Predictors of incidental gallbladder cancer in patients undergoing cholecystectomy for benign gallbladder disease. J Surg Oncol 107:118–123PubMedCrossRefGoogle Scholar
  9. 9.
    Chan KM, Yeh TS, Jan YY, Chen MF (2006) Laparoscopic cholecystectomy for early gallbladder carcinoma: long-term outcome in comparison with conventional open cholecystectomy. Surg Endosc 20:1867–1871PubMedCrossRefGoogle Scholar
  10. 10.
    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 13:25–33PubMedCrossRefGoogle Scholar
  11. 11.
    Sun CD, Zhang BY, Wu LQ, Lee WJ (2005) Laparoscopic cholecystectomy for treatment of unexpected early-stage gallbladder cancer. J Surg Oncol 91:253–257PubMedCrossRefGoogle Scholar
  12. 12.
    Cavallaro A, Piccolo G, Panebianco V, Lo Menzo E, Berretta M, Zanghi A, Di Vita M, Cappellani A (2012) Incidental gallbladder cancer during laparoscopic cholecystectomy: managing an unexpected finding. World J Gastroenterol 18:4019–4027PubMedCentralPubMedCrossRefGoogle Scholar
  13. 13.
    Misra MC, Guleria S (2006) Management of cancer gallbladder found as a surprise on a resected gallbladder specimen. J Surg Oncol 93:690–698PubMedCrossRefGoogle Scholar
  14. 14.
    Toyonaga T, Chijiiwa K, Nakano K, Noshiro H, Yamaguchi K, Sada M, Terasaka R, Konomi K, Nishikata F, Tanaka M (2003) Completion radical surgery after cholecystectomy for accidentally undiagnosed gallbladder carcinoma. World J Surg 27:266–271PubMedCrossRefGoogle Scholar
  15. 15.
    Varshney S, Butturini G, Gupta R (2002) Incidental carcinoma of the gallbladder. Eur J Surg Oncol 28:4–10PubMedCrossRefGoogle Scholar
  16. 16.
    Cangemi V, Fiori E, Picchi C, De Cesare A, Cangemi R, Galati G, Volpino P (2006) Early gallbladder carcinoma: a single-center experience. Tumori 92:487–490PubMedGoogle Scholar
  17. 17.
    Wakai T, Shirai Y, Hatakeyama K (2002) Radical second resection provides survival benefit for patients with T2 gallbladder carcinoma first discovered after laparoscopic cholecystectomy. World J Surg 26:867–871PubMedCrossRefGoogle Scholar
  18. 18.
    Shirai Y, Yoshida K, Tsukada K, Muto T (1992) Inapparent carcinoma of the gallbladder. An appraisal of a radical second operation after simple cholecystectomy. Ann Surg 215:326–331PubMedCentralPubMedCrossRefGoogle Scholar
  19. 19.
    de Aretxabala X, Roa I, Burgos L, Losada H, Roa JC, Mora J, Hepp J, Leon J, Maluenda F (2006) Gallbladder cancer: an analysis of a series of 139 patients with invasion restricted to the subserosal layer. J Gastrointest Surg 10:186–192PubMedCrossRefGoogle Scholar
  20. 20.
    Evrard S, Falkenrodt A, Park A, Tassetti V, Mutter D, Marescaux J (1997) Influence of CO2 pneumoperitoneum on systemic and peritoneal cell-mediated immunity. World J Surg 21:353–356 discussion 357PubMedCrossRefGoogle Scholar
  21. 21.
    Suzuki K, Kimura T, Ogawa H (2000) Long-term prognosis of gallbladder cancer diagnosed after laparoscopic cholecystectomy. Surg Endosc 14:712–716PubMedCrossRefGoogle Scholar
  22. 22.
    Wibbenmeyer LA, Wade TP, Chen RC, Meyer RC, Turgeon RP, Andrus CH (1995) Laparoscopic cholecystectomy can disseminate in situ carcinoma of the gallbladder. J Am Coll Surg 181:504–510PubMedGoogle Scholar
  23. 23.
    Yamaguchi K, Chijiiwa K, Ichimiya H, Sada M, Kawakami K, Nishikata F, Konomi K, Tanaka M (1996) Gallbladder carcinoma in the era of laparoscopic cholecystectomy. Arch Surg 131:981–984 discussion 985PubMedCrossRefGoogle Scholar
  24. 24.
    Chijiiwa K, Nakano K, Ueda J, Noshiro H, Nagai E, Yamaguchi K, Tanaka M (2001) Surgical treatment of patients with T2 gallbladder carcinoma invading the subserosal layer. J Am Coll Surg 192:600–607PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  1. 1.Department of SurgeryChiba Tokushukai HospitalFunabashiJapan
  2. 2.Department of SurgeryTamakyuryo HospitalTokyoJapan

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