Laparoscopic radical cholecystectomy with lymph node dissection for gallbladder carcinoma
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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.
KeywordsLaparoscopic 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.