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Surgical and Oncological Outcomes of Wedge Resection Versus Segment 4b + 5 Resection for T2 and T3 Gallbladder Cancer: a Meta-Analysis

  • Review Article
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Journal of Gastrointestinal Surgery

Abstract

Background

Liver resection is the standard operative procedure for patients with T2 and T3 gallbladder cancers (GBC). However, the optimal extent of hepatectomy remains unclear.

Methods

We conducted a systematic literature search and meta-analysis to assess the safety and long-term outcomes of wedge resection (WR) vs. segment 4b + 5 resection (SR) in patients with T2 and T3 GBC. We reviewed surgical outcomes (i.e., postoperative complications and bile leak) and oncological outcomes (i.e., liver metastasis, disease-free survival (DFS), and overall survival (OS)).

Results

The initial search yielded 1178 records. Seven studies reported assessments of the above-mentioned outcomes in 1795 patients. WR had significantly fewer postoperative complications than SR, with an odds ratio of 0.40 (95% confidence interval, 0.26 − 0.60; p < 0.001), although there were no significant differences in bile leak between WR and SR. There were no significant differences in oncological outcomes such as liver metastases, 5-year DFS, and OS.

Conclusions

For patients with both T2 and T3 GBC, WR was superior to SR in terms of surgical outcome and comparable to SR in terms of oncological outcomes. WR that achieves margin-negative resection may be a suitable procedure for patients with both T2 and T3 GBC.

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Data Availability

The data that support the findings of this study are openly available.

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Authors and Affiliations

  1. Department of Digestive Surgery, Tsuchiura Kyodo General Hospital, 4-1-1 Otuno, Tsuchiura-shi, Ibaraki, Japan

    Satoshi Matsui, Toshiro Tanioka, Kei Nakajima, Toshifumi Saito, Syunichiro Kato, Chiharu Tomii, Fumi Hasegawa, Syunsuke Muramatsu, Akio Kaito & Koji Ito

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  1. Satoshi Matsui
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Correspondence to Satoshi Matsui.

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Synopsis for Table of Contents

We conducted a systematic literature search and meta-analysis to assess the safety and long-term outcomes of wedge resection (WR) vs. segment 4b + 5 resection (SR) in patients with T2 and T3 GBC. In this meta-analysis, WR was superior to SR in terms of surgical outcome and comparable to SR in terms of oncological outcomes.

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Matsui, S., Tanioka, T., Nakajima, K. et al. Surgical and Oncological Outcomes of Wedge Resection Versus Segment 4b + 5 Resection for T2 and T3 Gallbladder Cancer: a Meta-Analysis. J Gastrointest Surg 27, 1954–1962 (2023). https://doi.org/10.1007/s11605-023-05698-6

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