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Laparoscopic surgery for oncologic extended resection of T1b and T2 incidental gallbladder carcinoma at a high-volume center: a single-center experience in China

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Abstract

Background

Surgical treatment is still the most effective treatment for gallbladder cancer. For the patients with stage T1b and above, the current guidelines recommend the extended radical operation, and oncologic extended resection can benefit the survival of the patients. The laparoscopic approach is still in the early phase, and its safety and oncological outcomes are not well known.

Objective

To evaluate the technical feasibility and oncological outcomes of laparoscopic surgery for oncologic extended resection of early-stage incidental gallbladder carcinoma.

Results

This study included 18 male and 32 female patients. Twenty patients underwent laparoscopic oncologic extended resection and 30 patients underwent open oncologic extended resection. All of the patients had R0 resection. A laparoscopic approach was associated with less intraoperative blood loss (242 ± 108.5 vs 401 ± 130.3; p < 0.01) and shorter duration of postoperative hospital stay (6.2 ± 2.4 vs 8.6 ± 2.3; p < 0.01). There was no statistically significant difference between two groups for lymph nodes yield (5.4 ± 3.5 vs 5.8 ± 2.1; p > 0.05), incidence of lymphatic metastasis (15% vs 16.67%; p > 0.05), residual disease (20% vs 23.3%; p > 0.05), and postoperative morbidity (15% vs 20%; p > 0.05). During follow-up time of median 20.95 (12–29.5) months, no significant difference was found between the two groups for early tumor recurrence (10% vs 13.33%; p > 0.05) and disease-free survival (p > 0.05).

Conclusion

Laparoscopic surgery may offer similar intraoperative, perioperative, and short-term oncological outcomes as an open oncologic extended resection for incidental gallbladder carcinoma.

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Funding

This study was funded by the Fundamental Research Funds for the Central Universities (2019SCUH) and Science & Technology Support Project of Sichuan Province (2018JY0019), and Post-Doctor Research Project, West China Hospital, Sichuan University (2019HXBH025).

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Authors and Affiliations

  1. Department of Biliary Surgery, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China

    Parbatraj Regmi, Hai-Jie Hu, Yin Chang-Hao, Fei Liu, Wen-Jie Ma, Cong-Dun Ran, Jun-Ke Wang, Aliza Paudyal, Nan-Sheng Cheng & Fu-Yu Li

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  1. Parbatraj Regmi
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Contributions

PR and H-JH contributed equally to the study and were the co-first authors. PR and H-JH contributed to data acquisition and drafted the manuscript. YC-H, FL, W-JM, C-DR, J-KW, and AP contributed to data acquisition. N-SC revised the manuscript. F-YL contributed to the study design and revision of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Fu-Yu Li.

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Disclosures

Parbatraj Regmi, Hai-Jie Hu, Yin Chang-Hao, Fei Liu, Wen-Jie Ma, Cong-Dun Ran, Jun-Ke Wang, Aliza Paudyal, Nan-Sheng Cheng, and Fu-Yu Li have no conflicts of interest or financial ties to disclose.

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Regmi, P., Hu, HJ., Chang-Hao, Y. et al. Laparoscopic surgery for oncologic extended resection of T1b and T2 incidental gallbladder carcinoma at a high-volume center: a single-center experience in China. Surg Endosc 35, 6505–6512 (2021). https://doi.org/10.1007/s00464-020-08146-7

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