Skip to main content

Surgical Management of Gallbladder Cancer Patients

  • Chapter
  • First Online:
Gallbladder Cancer

Abstract

Gallbladder cancer (GBC) is the most common biliary tract malignancy and remains highly lethal. The best survival is obtained if GBC is diagnosed at an early stage and complete (R0) resection is achieved. This chapter provides an overview of the current state of surgical management of GBC patients and is structured according to the patient’s presentation. First, epidemiology, risk factors, and staging are discussed, followed by an overview of the current indications for surgical treatment. Next, surgical approach is described in detail according to the mode of presentation: incidental GBC (i.e., intra- or postoperatively during routine cholecystectomy) or in symptomatic patients with findings suspicious for malignancy on imaging. Furthermore, surgical controversies such as the extent of resection are discussed. Finally, postoperative care and complications as well as adjuvant and palliative treatment are depicted.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 99.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 179.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Are C, Ahmad H, Ravipati A, Croo D, Clarey D, Smith L, et al. Global epidemiological trends and variations in the burden of gallbladder cancer. J Surg Oncol. 2017;115(5):580–90.

    Article  Google Scholar 

  2. Diehl AK, Beral V. Cholecystectomy and changing mortality from gallbladder cancer. Lancet. 1981;2(8239):187–9.

    Article  CAS  Google Scholar 

  3. Rawla P, Sunkara T, Thandra KC, Barsouk A. Epidemiology of gallbladder cancer. Clin Exp Hepatol. 2019;5(2):93–102.

    Article  Google Scholar 

  4. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394–424.

    Article  Google Scholar 

  5. Gamboa AC, Maithel SK. The landmark series: gallbladder cancer. Ann Surg Oncol. 2020;27(8):2846–58.

    Article  Google Scholar 

  6. Shin A, Song YM, Yoo KY, Sung J. Menstrual factors and cancer risk among Korean women. Int J Epidemiol. 2011;40(5):1261–8.

    Article  Google Scholar 

  7. Abou-Alfa GKJW, Lowery M. Abeloff’s clinical oncology. Philadelphia: Saunders; 2014.

    Google Scholar 

  8. Randi G, Franceschi S, La Vecchia C. Gallbladder cancer worldwide: geographical distribution and risk factors. Int J Cancer. 2006;118(7):1591–602.

    Article  CAS  Google Scholar 

  9. Diehl AK. Gallstone size and the risk of gallbladder cancer. JAMA. 1983;250(17):2323–6.

    Article  CAS  Google Scholar 

  10. Hsing AW, Bai Y, Andreotti G, Rashid A, Deng J, Chen J, et al. Family history of gallstones and the risk of biliary tract cancer and gallstones: a population-based study in Shanghai, China. Int J Cancer. 2007;121(4):832–8.

    Article  CAS  Google Scholar 

  11. Agarwal R, Pandey RP, Gupta SN. Porcelain gall bladder. J Indian Med Assoc. 1982;79(5–6):80–1.

    CAS  Google Scholar 

  12. Schnelldorfer T. Porcelain gallbladder: a benign process or concern for malignancy? J Gastrointest Surg. 2013;17(6):1161–8.

    Article  Google Scholar 

  13. Machado NO. Porcelain gallbladder: decoding the malignant truth. Sultan Qaboos Univ Med J. 2016;16(4):e416–e21.

    Article  Google Scholar 

  14. Stephen AE, Berger DL. Carcinoma in the porcelain gallbladder: a relationship revisited. Surgery. 2001;129(6):699–703.

    Article  CAS  Google Scholar 

  15. Lai CH, Lau WY. Gallbladder cancer--a comprehensive review. Surgeon. 2008;6(2):101–10.

    Article  Google Scholar 

  16. Aloia TA, Járufe N, Javle M, Maithel SK, Roa JC, Adsay V, et al. Gallbladder cancer: expert consensus statement. HPB (Oxford). 2015;17(8):681–90.

    Article  Google Scholar 

  17. Fong Y, Jarnagin W, Blumgart LH. Gallbladder cancer: comparison of patients presenting initially for definitive operation with those presenting after prior noncurative intervention. Ann Surg. 2000;232(4):557–69.

    Article  CAS  Google Scholar 

  18. Benson AB 3rd, D'Angelica MI, Abbott DE, Abrams TA, Alberts SR, Saenz DA, et al. NCCN guidelines insights: hepatobiliary cancers, version 1.2017. J Natl Compr Cancer Netw. 2017;15(5):563–73.

    Article  Google Scholar 

  19. Amin MBES, Greene FL. AJCC cancer staging manual. 8th ed. New York: Springer; 2017.

    Book  Google Scholar 

  20. Reid KM, Ramos-De la Medina A, Donohue JH. Diagnosis and surgical management of gallbladder cancer: a review. J Gastrointest Surg. 2007;11(5):671–81.

    Article  Google Scholar 

  21. Yamaguchi K, Chijiiwa K, Shimizu S, Yokohata K, Tsuneyoshi M, Tanaka M. Anatomical limit of extended cholecystectomy for gallbladder carcinoma involving the neck of the gallbladder. Int Surg. 1998;83(1):21–3.

    CAS  Google Scholar 

  22. Samuel S, Mukherjee S, Ammannagari N, Pokuri VK, Kuvshinoff B, Groman A, et al. Clinicopathological characteristics and outcomes of rare histologic subtypes of gallbladder cancer over two decades: a population-based study. PLoS One. 2018;13(6):e0198809.

    Article  Google Scholar 

  23. Shirai Y, Yoshida K, Tsukada K, Ohtani T, Muto T. Identification of the regional lymphatic system of the gallbladder by vital staining. Br J Surg. 1992;79(7):659–62.

    Article  CAS  Google Scholar 

  24. Chaffer CL, Weinberg RA. A perspective on cancer cell metastasis. Science. 2011;331(6024):1559–64.

    Article  CAS  Google Scholar 

  25. Hennedige TP, Neo WT, Venkatesh SK. Imaging of malignancies of the biliary tract- an update. Cancer Imaging. 2014;14(1):14.

    Google Scholar 

  26. Xie XH, Xu HX, Xie XY, Lu MD, Kuang M, Xu ZF, et al. Differential diagnosis between benign and malignant gallbladder diseases with real-time contrast-enhanced ultrasound. Eur Radiol. 2010;20(1):239–48.

    Article  Google Scholar 

  27. Jang JY, Kim SW, Lee SE, Hwang DW, Kim EJ, Lee JY, et al. Differential diagnostic and staging accuracies of high resolution ultrasonography, endoscopic ultrasonography, and multidetector computed tomography for gallbladder polypoid lesions and gallbladder cancer. Ann Surg. 2009;250(6):943–9.

    Article  Google Scholar 

  28. Joo I, Lee JY, Baek JH, Kim JH, Park HS, Han JK, et al. Preoperative differentiation between T1a and ≥T1b gallbladder cancer: combined interpretation of high-resolution ultrasound and multidetector-row computed tomography. Eur Radiol. 2014;24(8):1828–34.

    Article  Google Scholar 

  29. Lee JS, Kim JH, Kim YJ, Ryu JK, Kim YT, Lee JY, et al. Diagnostic accuracy of transabdominal high-resolution US for staging gallbladder cancer and differential diagnosis of neoplastic polyps compared with EUS. Eur Radiol. 2017;27(7):3097–103.

    Article  Google Scholar 

  30. Fujita N, Noda Y, Kobayashi G, Kimura K, Yago A. Diagnosis of the depth of invasion of gallbladder carcinoma by EUS. Gastrointest Endosc. 1999;50(5):659–63.

    Article  CAS  Google Scholar 

  31. Imazu H, Mori N, Kanazawa K, Chiba M, Toyoizumi H, Torisu Y, et al. Contrast-enhanced harmonic endoscopic ultrasonography in the differential diagnosis of gallbladder wall thickening. Dig Dis Sci. 2014;59(8):1909–16.

    Article  Google Scholar 

  32. Kim SJ, Lee JM, Lee JY, Kim SH, Han JK, Choi BI, et al. Analysis of enhancement pattern of flat gallbladder wall thickening on MDCT to differentiate gallbladder cancer from cholecystitis. AJR Am J Roentgenol. 2008;191(3):765–71.

    Article  Google Scholar 

  33. Tongdee R, Maroongroge P, Suthikeree W. The value of MDCT scans in differentiation between benign and malignant gallbladder wall thickening. J Med Assoc Thail. 2011;94(5):592–600.

    Google Scholar 

  34. Kuipers H, Hoogwater FJH, Holtman GA, Slangen JJG, de Haas RJ, de Boer MT. Diagnostic performance of preoperative CT in differentiating between benign and malignant origin of suspicious gallbladder lesions. Eur J Radiol. 2021;138:109619.

    Article  Google Scholar 

  35. Kalra N, Suri S, Gupta R, Natarajan SK, Khandelwal N, Wig JD, et al. MDCT in the staging of gallbladder carcinoma. AJR Am J Roentgenol. 2006;186(3):758–62.

    Article  Google Scholar 

  36. Demachi H, Matsui O, Hoshiba K, Kimura M, Miyata S, Kuroda Y, et al. Dynamic MRI using a surface coil in chronic cholecystitis and gallbladder carcinoma: radiologic and histopathologic correlation. J Comput Assist Tomogr. 1997;21(4):643–51.

    Article  CAS  Google Scholar 

  37. Jung SE, Lee JM, Lee K, Rha SE, Choi BG, Kim EK, et al. Gallbladder wall thickening: MR imaging and pathologic correlation with emphasis on layered pattern. Eur Radiol. 2005;15(4):694–701.

    Article  CAS  Google Scholar 

  38. Eaton JE, Thackeray EW, Lindor KD. Likelihood of malignancy in gallbladder polyps and outcomes following cholecystectomy in primary sclerosing cholangitis. Am J Gastroenterol. 2012;107(3):431–9.

    Article  Google Scholar 

  39. Schwartz LH, Black J, Fong Y, Jarnagin W, Blumgart L, Gruen D, et al. Gallbladder carcinoma: findings at MR imaging with MR cholangiopancreatography. J Comput Assist Tomogr. 2002;26(3):405–10.

    Article  Google Scholar 

  40. Kaza RK, Gulati M, Wig JD, Chawla YK. Evaluation of gall bladder carcinoma with dynamic magnetic resonance imaging and magnetic resonance cholangiopancreatography. Australas Radiol. 2006;50(3):212–7.

    Article  CAS  Google Scholar 

  41. Kim JH, Kim TK, Eun HW, Kim BS, Lee MG, Kim PN, et al. Preoperative evaluation of gallbladder carcinoma: efficacy of combined use of MR imaging, MR cholangiography, and contrast-enhanced dual-phase three-dimensional MR angiography. J Magn Reson Imaging. 2002;16(6):676–84.

    Article  Google Scholar 

  42. Choi SY, Kim JH, Park HJ, Han JK. Preoperative CT findings for prediction of resectability in patients with gallbladder cancer. Eur Radiol. 2019;29(12):6458–68.

    Article  Google Scholar 

  43. de Savornin Lohman EAJ, de Bitter TJJ, van Laarhoven C, Hermans JJ, de Haas RJ, de Reuver PR. The diagnostic accuracy of CT and MRI for the detection of lymph node metastases in gallbladder cancer: a systematic review and meta-analysis. Eur J Radiol. 2019;110:156–62.

    Article  Google Scholar 

  44. Ramos-Font C, Gómez Río M, Rodríguez-Fernández A, Sánchez Sánchez R, Llamas Elvira JM. [Positron tomography with 18F-fluorodeoxyglucose in the preoperative evaluation of gall bladder lesions suspicious of malignancy. Diagnostic utility and clinical impact] Tomografía por emisión de positrones con (18)F-fluorodesoxiglucosa en la evaluación preoperatoria de lesiones de vesícula biliar sospechosas de malignidad. Utilidad diagnóstica e impacto clínico. Rev Esp Med Nucl. 2011;30(5):267–75.

    Article  CAS  Google Scholar 

  45. Lee SW, Kim HJ, Park JH, Park DI, Cho YK, Sohn CI, et al. Clinical usefulness of 18F-FDG PET-CT for patients with gallbladder cancer and cholangiocarcinoma. J Gastroenterol. 2010;45(5):560–6.

    Article  Google Scholar 

  46. Petrowsky H, Wildbrett P, Husarik DB, Hany TF, Tam S, Jochum W, et al. Impact of integrated positron emission tomography and computed tomography on staging and management of gallbladder cancer and cholangiocarcinoma. J Hepatol. 2006;45(1):43–50.

    Article  Google Scholar 

  47. Corvera CU, Blumgart LH, Akhurst T, DeMatteo RP, D'Angelica M, Fong Y, et al. 18F-fluorodeoxyglucose positron emission tomography influences management decisions in patients with biliary cancer. J Am Coll Surg. 2008;206(1):57–65.

    Article  Google Scholar 

  48. Butte JM, Redondo F, Waugh E, Meneses M, Pruzzo R, Parada H, et al. The role of PET-CT in patients with incidental gallbladder cancer. HPB (Oxford). 2009;11(7):585–91.

    Article  Google Scholar 

  49. Singla V, Agarwal R, Anikhindi SA, Puri P, Kumar M, Ranjan P, et al. Role of EUS-FNA for gallbladder mass lesions with biliary obstruction: a large single-center experience. Endosc Int Open. 2019;7(11):E1403–E9.

    Article  Google Scholar 

  50. Vollmer CM, Drebin JA, Middleton WD, Teefey SA, Linehan DC, Soper NJ, et al. Utility of staging laparoscopy in subsets of peripancreatic and biliary malignancies. Ann Surg. 2002;235(1):1–7.

    Article  Google Scholar 

  51. Zhuang PY, Tang ZH, Liu YB, Quan ZW, Zhang YJ. Diagnostic and prognostic role of laparoscopic staging for gallbladder carcinoma. Dig Surg. 2012;29(5):367–73.

    Article  Google Scholar 

  52. Agarwal AK, Kalayarasan R, Javed A, Gupta N, Nag HH. The 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. 2013;258(2):318–23.

    Article  Google Scholar 

  53. Butte JM, Gönen M, Allen PJ, D'Angelica MI, Kingham TP, Fong Y, et al. The role of laparoscopic staging in patients with incidental gallbladder cancer. HPB (Oxford). 2011;13(7):463–72.

    Article  Google Scholar 

  54. Shimada H, Endo I, Fujii Y, Kamiya N, Masunari H, Kunihiro O, et al. Appraisal of surgical resection of gallbladder cancer with special reference to lymph node dissection. Langenbeck’s Arch Surg. 2000;385(8):509–14.

    Article  CAS  Google Scholar 

  55. Lee SE, Jang JY, Kim SW, Han HS, Kim HJ, Yun SS, et al. Surgical strategy for T1 gallbladder cancer: a nationwide multicenter survey in South Korea. Ann Surg Oncol. 2014;21(11):3654–60.

    Article  Google Scholar 

  56. Benoist S, Panis Y, Fagniez PL. Long-term results after curative resection for carcinoma of the gallbladder. French University Association for Surgical Research. Am J Surg. 1998;175(2):118–22.

    Article  CAS  Google Scholar 

  57. You DD, Lee HG, Paik KY, Heo JS, Choi SH, Choi DW. What is an adequate extent of resection for T1 gallbladder cancers? Ann Surg. 2008;247(5):835–8.

    Article  Google Scholar 

  58. de Savornin Lohman EAJ, van der Geest LG, de Bitter TJJ, Nagtegaal ID, van Laarhoven C, van den Boezem P, et al. Re-resection in incidental gallbladder cancer: survival and the incidence of residual disease. Ann Surg Oncol. 2020;27(4):1132–42.

    Article  Google Scholar 

  59. Yoon JH, Lee YJ, Kim SC, Lee JH, Song KB, Hwang JW, et al. What is the better choice for T1b gallbladder cancer: simple versus extended cholecystectomy. World J Surg. 2014;38(12):3222–7.

    Article  Google Scholar 

  60. Søreide K, Guest RV, Harrison EM, Kendall TJ, Garden OJ, Wigmore SJ. Systematic review of management of incidental gallbladder cancer after cholecystectomy. Br J Surg. 2019;106(1):32–45.

    Article  Google Scholar 

  61. Kim BH, Kim SH, Song IS, Chun GS. The appropriate surgical strategy for T1b gallbladder cancer incidentally diagnosed after a simple cholecystectomy. Ann Hepatobiliary Pancreat Surg. 2019;23(4):327–33.

    Article  Google Scholar 

  62. Kim HS, Park JW, Kim H, Han Y, Kwon W, Kim SW, et al. Optimal surgical treatment in patients with T1b gallbladder cancer: an international multicenter study. J Hepatobiliary Pancreat Sci. 2018;25(12):533–43.

    Article  Google Scholar 

  63. Lee H, Kwon W, Han Y, Kim JR, Kim SW, Jang JY. Optimal extent of surgery for early gallbladder cancer with regard to long-term survival: a meta-analysis. J Hepatobiliary Pancreat Sci. 2018;25(2):131–41.

    Article  Google Scholar 

  64. Sternby Eilard M, Lundgren L, Cahlin C, Strandell A, Svanberg T, Sandström P. Surgical treatment for gallbladder cancer - a systematic literature review. Scand J Gastroenterol. 2017;52(5):505–14.

    Article  Google Scholar 

  65. Eckel F, Brunner T, Jelic S, Group EGW. Biliary cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2010;21(Suppl 5):v65–9.

    Article  Google Scholar 

  66. Chijiiwa K, Nakano K, Ueda J, Noshiro H, Nagai E, Yamaguchi K, et al. Surgical treatment of patients with T2 gallbladder carcinoma invading the subserosal layer. J Am Coll Surg. 2001;192(5):600–7.

    Article  CAS  Google Scholar 

  67. Goetze TO, Paolucci V. Adequate extent in radical re-resection of incidental gallbladder carcinoma: analysis of the German Registry. Surg Endosc. 2010;24(9):2156–64.

    Article  Google Scholar 

  68. Araida T, Higuchi R, Hamano M, Kodera Y, Takeshita N, Ota T, et al. Hepatic resection in 485 R0 pT2 and pT3 cases of advanced carcinoma of the gallbladder: results of a Japanese Society of Biliary Surgery survey--a multicenter study. J Hepato-Biliary-Pancreat Surg. 2009;16(2):204–15.

    Article  Google Scholar 

  69. Horiguchi A, Miyakawa S, Ishihara S, Miyazaki M, Ohtsuka M, Shimizu H, et al. 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. 2013;20(5):518–24.

    Article  Google Scholar 

  70. Wakai T, Shirai Y, Sakata J, Tsuchiya Y, Nomura T, Hatakeyama K. Surgical outcomes of minor hepatectomy for locally advanced gallbladder carcinoma. Hepato-Gastroenterology. 2012;59(119):2083–8.

    Google Scholar 

  71. Jiang W, Zhao B, Li Y, Qi D, Wang D. Modification of the 8th American joint committee on cancer staging system for gallbladder carcinoma to improve prognostic precision. BMC Cancer. 2020;20(1):1129.

    Article  CAS  Google Scholar 

  72. Zhang W, Hong HJ, Chen YL. Establishment of a gallbladder cancer-specific survival model to predict prognosis in non-metastatic gallbladder cancer patients after surgical resection. Dig Dis Sci. 2018;63(9):2251–8.

    Article  Google Scholar 

  73. Chen M, Cao J, Zhang B, Pan L, Cai X. A nomogram for prediction of overall survival in patients with node-negative gallbladder cancer. J Cancer. 2019;10(14):3246–52.

    Article  Google Scholar 

  74. Ethun CG, Postlewait LM, Le N, Pawlik TM, Buettner S, Poultsides G, et al. A novel pathology-based preoperative risk score to predict locoregional residual and distant disease and survival for incidental gallbladder cancer: a 10-institution study from the U.S. extrahepatic biliary malignancy consortium. Ann Surg Oncol. 2017;24(5):1343–50.

    Article  Google Scholar 

  75. Yifan T, Zheyong L, Miaoqin C, Liang S, Xiujun C. A predictive model for survival of gallbladder adenocarcinoma. Surg Oncol. 2018;27(3):365–72.

    Article  Google Scholar 

  76. Blakely AM, Wong P, Chu P, Warner SG, Raoof M, Singh G, et al. Intraoperative bile spillage is associated with worse survival in gallbladder adenocarcinoma. J Surg Oncol. 2019;120(4):603–10.

    CAS  Google Scholar 

  77. Horkoff MJ, Ahmed Z, Xu Y, Sutherland FR, Dixon E, Ball CG, et al. Adverse outcomes after bile spillage in incidental gallbladder cancers: a population-based study. Ann Surg. 2021;273(1):139–44.

    Article  Google Scholar 

  78. Hawkins WG, DeMatteo RP, Jarnagin WR, Ben-Porat L, Blumgart LH, Fong Y. Jaundice predicts advanced disease and early mortality in patients with gallbladder cancer. Ann Surg Oncol. 2004;11(3):310–5.

    Article  Google Scholar 

  79. Ramos E, Lluis N, Llado L, Torras J, Busquets J, Rafecas A, et al. Prognostic value and risk stratification of residual disease in patients with incidental gallbladder cancer. World J Surg Oncol. 2020;18(1):18.

    Article  Google Scholar 

  80. Ando T, Sakata J, Nomura T, Takano K, Takizawa K, Miura K, et al. Anatomic location of residual disease after initial cholecystectomy independently determines outcomes after re-resection for incidental gallbladder cancer. Langenbecks Arch Surg. 2021;406(5):1521–32.

    Article  Google Scholar 

  81. Creasy JM, Goldman DA, Gonen M, Dudeja V, Askan G, Basturk O, et al. Predicting residual disease in incidental gallbladder cancer: risk stratification for modified treatment strategies. J Gastrointest Surg. 2017;21(8):1254–61.

    Article  Google Scholar 

  82. Zhou Y, Zhang Z, Wu L, Li B. A systematic review of safety and efficacy of hepatopancreatoduodenectomy for biliary and gallbladder cancers. HPB (Oxford). 2016;18(1):1–6.

    Article  Google Scholar 

  83. Kuipers H, de Savornin Lohman EAJ, van Dooren M, Braat AE, Daams F, van Dam R, et al. Extended resections for advanced gallbladder cancer: results from a Nationwide cohort study. Ann Surg Oncol. 2021;28(2):835–43.

    Article  CAS  Google Scholar 

  84. Sakamoto Y, Nara S, Kishi Y, Esaki M, Shimada K, Kokudo N, et al. Is extended hemihepatectomy plus pancreaticoduodenectomy justified for advanced bile duct cancer and gallbladder cancer? Surgery. 2013;153(6):794–800.

    Article  Google Scholar 

  85. Wang J, Bo X, Nan L, Wang CC, Gao Z, Suo T, et al. Landscape of distant metastasis mode and current chemotherapy efficacy of the advanced biliary tract cancer in the United States, 2010-2016. Cancer Med. 2020;9(4):1335–48.

    Article  Google Scholar 

  86. Yang Y, Tu Z, Ye C, Cai H, Yang S, Chen X, et al. Site-specific metastases of gallbladder adenocarcinoma and their prognostic value for survival: a SEER-based study. BMC Surg. 2021;21(1):59.

    Article  CAS  Google Scholar 

  87. Kapoor VK. Gallbladder neck cancer and perihilar cholangiocarcinoma - siblings, cousins or look alikes? Korean J Hepatobiliary Pancreat Surg. 2015;19(2):86–8.

    Article  Google Scholar 

  88. Hertl M, Cosimi AB. Liver transplantation for malignancy. Oncologist. 2005;10(4):269–81.

    Article  Google Scholar 

  89. Grossman EJ, Millis JM. Liver transplantation for non-hepatocellular carcinoma malignancy: indications, limitations, and analysis of the current literature. Liver Transpl. 2010;16(8):930–42.

    Article  Google Scholar 

  90. Ethun CG, Le N, Lopez-Aguiar AG, Pawlik TM, Poultsides G, Tran T, et al. Pathologic and prognostic implications of incidental versus nonincidental gallbladder cancer: a 10-institution study from the United States extrahepatic biliary malignancy consortium. Am Surg. 2017;83(7):679–86.

    Article  Google Scholar 

  91. Kwon AH, Imamura A, Kitade H, Kamiyama Y. Unsuspected gallbladder cancer diagnosed during or after laparoscopic cholecystectomy. J Surg Oncol. 2008;97(3):241–5.

    Article  Google Scholar 

  92. Koppatz H, Nordin A, Scheinin T, Sallinen V. The risk of incidental gallbladder cancer is negligible in macroscopically normal cholecystectomy specimens. HPB (Oxford). 2018;20(5):456–61.

    Article  Google Scholar 

  93. Emmett CD, Barrett P, Gilliam AD, Mitchell AI. Routine versus selective histological examination after cholecystectomy to exclude incidental gallbladder carcinoma. Ann R Coll Surg Engl. 2015;97(7):526–9.

    Article  CAS  Google Scholar 

  94. Jamal K, Ratansingham K, Siddique M, Nehra D. Routine histological analysis of a macroscopically normal gallbladder--a review of the literature. Int J Surg. 2014;12(9):958–62.

    Article  CAS  Google Scholar 

  95. Hueman MT, Vollmer CM Jr, Pawlik TM. Evolving treatment strategies for gallbladder cancer. Ann Surg Oncol. 2009;16(8):2101–15.

    Article  Google Scholar 

  96. Shih SP, Schulick RD, Cameron JL, Lillemoe KD, Pitt HA, Choti MA, et al. Gallbladder cancer: the role of laparoscopy and radical resection. Ann Surg. 2007;245(6):893–901.

    Article  Google Scholar 

  97. Steinert R, Nestler G, Sagynaliev E, Müller J, Lippert H, Reymond MA. Laparoscopic cholecystectomy and gallbladder cancer. J Surg Oncol. 2006;93(8):682–9.

    Article  Google Scholar 

  98. Han HS, Yoon YS, Agarwal AK, Belli G, Itano O, Gumbs AA, et al. Laparoscopic surgery for gallbladder cancer: an expert consensus statement. Dig Surg. 2019;36(1):1–6.

    Article  CAS  Google Scholar 

  99. Zhao X, Li XY, Ji W. Laparoscopic versus open treatment of gallbladder cancer: a systematic review and meta-analysis. J Minim Access Surg. 2018;14(3):185–91.

    Article  Google Scholar 

  100. Goetze TO, Paolucci V. Prognosis of incidental gallbladder carcinoma is not influenced by the primary access technique: analysis of 837 incidental gallbladder carcinomas in the German registry. Surg Endosc. 2013;27(8):2821–8.

    Article  Google Scholar 

  101. Hijioka S, Mekky MA, Bhatia V, Sawaki A, Mizuno N, Hara K, et al. Can EUS-guided FNA distinguish between gallbladder cancer and xanthogranulomatous cholecystitis? Gastrointest Endosc. 2010;72(3):622–7.

    Article  Google Scholar 

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

    Article  Google Scholar 

  103. Viganò L, Ferrero A, Amisano M, Russolillo N, Capussotti L. Comparison of laparoscopic and open intraoperative ultrasonography for staging liver tumours. Br J Surg. 2013;100(4):535–42.

    Article  Google Scholar 

  104. Pandey D. Technical description of a regional lymphadenectomy in radical surgery for gallbladder cancer. HPB (Oxford). 2012;14(3):216–9.

    Article  Google Scholar 

  105. Agarwal AK, Kalayarasan R, Javed A, Sakhuja P. Role of routine 16b1 lymph node biopsy in the management of gallbladder cancer: an analysis. HPB (Oxford). 2014;16(3):229–34.

    Article  Google Scholar 

  106. Varma V, Gupta S, Soin AS, Nundy S. Does the presence of jaundice and/or a lump in a patient with gall bladder cancer mean that the lesion is not resectable? Dig Surg. 2009;26(4):306–11.

    Article  Google Scholar 

  107. de Savornin Lohman EAJ, Kuipers H, van Dooren M, Verhoeven RHA, Erdmann JI, Groot Koerkamp B, et al. Should jaundice preclude resection in patients with gallbladder cancer? Results from a nation-wide cohort study. HPB (Oxford). 2020;22(12):1686–94.

    Article  Google Scholar 

  108. Wiggers JK, Groot Koerkamp B, Ovadia Z, Busch OR, Gouma DJ, van Gulik TM. Patterns of recurrence after resection of gallbladder cancer without routine extrahepatic bile duct resection. HPB (Oxford). 2014;16(7):635–40.

    Article  Google Scholar 

  109. Pawlik TM, Gleisner AL, Vigano L, Kooby DA, Bauer TW, Frilling A, et al. Incidence of finding residual disease for incidental gallbladder carcinoma: implications for re-resection. J Gastrointest Surg. 2007;11(11):1478–86. discussion 86-7.

    Article  Google Scholar 

  110. D'Angelica M, Dalal KM, DeMatteo RP, Fong Y, Blumgart LH, Jarnagin WR. Analysis of the extent of resection for adenocarcinoma of the gallbladder. Ann Surg Oncol. 2009;16(4):806–16.

    Article  Google Scholar 

  111. Ferrero A, Lo Tesoriere R, Russolillo N, Viganò L, Forchino F, Capussotti L. Ultrasound-guided laparoscopic liver resections. Surg Endosc. 2015;29(4):1002–5.

    Article  Google Scholar 

  112. Dezfouli SA, Ünal UK, Ghamarnejad O, Khajeh E, Ali-Hasan-Al-Saegh S, Ramouz A, et al. Systematic review and meta-analysis of the efficacy of prophylactic abdominal drainage in major liver resections. Sci Rep. 2021;11(1):3095.

    Article  CAS  Google Scholar 

  113. Machado MA, Makdissi FF, Surjan RC. Totally laparoscopic hepatic bisegmentectomy (s4b+s5) and hilar lymphadenectomy for incidental gallbladder cancer. Ann Surg Oncol. 2015;22(Suppl 3):S336–9.

    Article  Google Scholar 

  114. Agarwal AK, Javed A, Kalayarasan R, Sakhuja P. Minimally invasive versus the conventional open surgical approach of a radical cholecystectomy for gallbladder cancer: a retrospective comparative study. HPB (Oxford). 2015;17(6):536–41.

    Article  Google Scholar 

  115. Palanisamy S, Patel N, Sabnis S, Palanisamy N, Vijay A, Palanivelu P, et al. Laparoscopic radical cholecystectomy for suspected early gall bladder carcinoma: thinking beyond convention. Surg Endosc. 2016;30(6):2442–8.

    Article  Google Scholar 

  116. Vega EA, Sanhueza M, Viñuela E. Minimally invasive surgery for gallbladder cancer. Surg Oncol Clin N Am. 2019;28(2):243–53.

    Article  Google Scholar 

  117. Goel M, Khobragade K, Patkar S, Kanetkar A, Kurunkar S. Robotic surgery for gallbladder cancer: operative technique and early outcomes. J Surg Oncol. 2019;119(7):958–63.

    Article  Google Scholar 

  118. Byun Y, Choi YJ, Kang JS, Han Y, Kim H, Kwon W, et al. Robotic extended cholecystectomy in gallbladder cancer. Surg Endosc. 2020;34(7):3256–61.

    Article  Google Scholar 

  119. Ethun CG, Postlewait LM, Le N, Pawlik TM, Buettner S, Poultsides G, et al. Association of optimal time interval to re-resection for incidental gallbladder cancer with overall survival: a multi-institution analysis from the US extrahepatic biliary malignancy consortium. JAMA Surg. 2017;152(2):143–9.

    Article  Google Scholar 

  120. Vega EA, De Aretxabala X, Qiao W, Newhook TE, Okuno M, Castillo F, et al. Comparison of oncological outcomes after open and laparoscopic re-resection of incidental gallbladder cancer. Br J Surg. 2020;107(3):289–300.

    Article  CAS  Google Scholar 

  121. Fuks D, Regimbeau JM, Pessaux P, Bachellier P, Raventos A, Mantion G, et al. Is port-site resection necessary in the surgical management of gallbladder cancer? J Visc Surg. 2013;150(4):277–84.

    Article  CAS  Google Scholar 

  122. Maker AV, Butte JM, Oxenberg J, Kuk D, Gonen M, Fong Y, et al. Is port site resection necessary in the surgical management of gallbladder cancer? Ann Surg Oncol. 2012;19(2):409–17.

    Article  Google Scholar 

  123. Valle JW, Borbath I, Khan SA, Huguet F, Gruenberger T, Arnold D, et al. Biliary cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2016;27(suppl 5):v28–37.

    Article  CAS  Google Scholar 

  124. Rahbari NN, Garden OJ, Padbury R, Maddern G, Koch M, Hugh TJ, et al. Post-hepatectomy haemorrhage: a definition and grading by the international study Group of Liver Surgery (ISGLS). HPB (Oxford). 2011;13(8):528–35.

    Article  Google Scholar 

  125. Ray S, Mehta NN, Golhar A, Nundy S. Post hepatectomy liver failure - a comprehensive review of current concepts and controversies. Ann Med Surg (Lond). 2018;34:4–10.

    Article  CAS  Google Scholar 

  126. Mantripragada KC, Hamid F, Shafqat H, Olszewski AJ. Adjuvant therapy for resected gallbladder cancer: analysis of the National Cancer Data Base. J Natl Cancer Inst. 2017;109(2):djw202.

    Article  Google Scholar 

  127. Jarnagin WR, Ruo L, Little SA, Klimstra D, D'Angelica M, DeMatteo RP, et al. Patterns of initial disease recurrence after resection of gallbladder carcinoma and hilar cholangiocarcinoma: implications for adjuvant therapeutic strategies. Cancer. 2003;98(8):1689–700.

    Article  Google Scholar 

  128. Primrose JN, Fox RP, Palmer DH, Malik HZ, Prasad R, Mirza D, et al. Capecitabine compared with observation in resected biliary tract cancer (BILCAP): a randomised, controlled, multicentre, phase 3 study. Lancet Oncol. 2019;20(5):663–73.

    Article  CAS  Google Scholar 

  129. Gupta A, Gupta S, Chauhan U, Kumar U, Sharma N, Ahuja R, et al. Symptom palliation in advanced GallBladder cancer: an institutional experience. Indian J Palliat Care. 2019;25(4):514–6.

    Article  Google Scholar 

  130. Thornton RH, Ulrich R, Hsu M, Moskowitz C, Reidy-Lagunes D, Covey AM, et al. Outcomes of patients undergoing percutaneous biliary drainage to reduce bilirubin for administration of chemotherapy. J Vasc Interv Radiol. 2012;23(1):89–95.

    Article  Google Scholar 

  131. Levy JL, Sudheendra D, Dagli M, Mondschein JI, Stavropoulos SW, Shlansky-Goldberg RD, et al. Percutaneous biliary drainage effectively lowers serum bilirubin to permit chemotherapy treatment. Abdom Radiol (NY). 2016;41(2):317–23.

    Article  Google Scholar 

  132. Saluja SS, Gulati M, Garg PK, Pal H, Pal S, Sahni P, et al. Endoscopic or percutaneous biliary drainage for gallbladder cancer: a randomized trial and quality of life assessment. Clin Gastroenterol Hepatol. 2008;6(8):944–50 e3.

    Article  Google Scholar 

  133. Tringali A, Giannetti A, Adler DG. Endoscopic management of gastric outlet obstruction disease. Ann Gastroenterol. 2019;32(4):330–7.

    Google Scholar 

  134. DeLeon TT, Ahn DH, Bogenberger JM, Anastasiadis PZ, Arora M, Ramanathan RK, et al. Novel targeted therapy strategies for biliary tract cancers and hepatocellular carcinoma. Future Oncol. 2018;14(6):553–66.

    Article  CAS  Google Scholar 

  135. Sicklick JK, Fanta PT, Shimabukuro K, Kurzrock R. Genomics of gallbladder cancer: the case for biomarker-driven clinical trial design. Cancer Metastasis Rev. 2016;35(2):263–75.

    Article  CAS  Google Scholar 

  136. Jensen LH, Lindebjerg J, Ploen J, Hansen TF, Jakobsen A. Phase II marker-driven trial of panitumumab and chemotherapy in KRAS wild-type biliary tract cancer. Ann Oncol. 2012;23(9):2341–6.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Bas Groot Koerkamp .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2023 The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Cappelle, M., de Savornin Lohman, E., de Reuver, P., Koerkamp, B.G. (2023). Surgical Management of Gallbladder Cancer Patients. In: Kumar Shukla, V., Pandey, M., Dixit, R. (eds) Gallbladder Cancer. Springer, Singapore. https://doi.org/10.1007/978-981-19-6442-8_2

Download citation

  • DOI: https://doi.org/10.1007/978-981-19-6442-8_2

  • Published:

  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-19-6441-1

  • Online ISBN: 978-981-19-6442-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics