Laparoscopic cholecystectomy in the treatment of patients with gallbladder cancer1

Yoshida, Takanori; Matsumoto, Toshifumi; Sasaki, Atsushi; Morii, Yuji; Ishio, Tetsuya; Bandoh, Toshio; Kitano, Seigo

doi:10.1016/s1072-7515(00)00285-4

Cited by 42 publications

(32 citation statements)

References 20 publications

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“…On the other hand, recently some reports show that the prognosis of patients with incidental gallbladder carcinoma is similar between those resected by laparoscopic approach and open approach [171][172][173][174]. However, in LC, the dissection plane on the liver side is within the subserosal layer.…”

Section: Cq16: What Are Considered As Unresectable Factors In Biliarymentioning

confidence: 97%

Clinical practice guidelines for the management of biliary tract cancers 2015: the 2^nd English edition

Miyazaki

Yoshitomi

Miyakawa³

et al. 2015

J Hepato Biliary Pancreat

237

165

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Background The Japanese Society of Hepato-Biliary-Pancreatic Surgery launched the clinical practice guidelines for the management of biliary tract and ampullary carcinomas in 2008. Novel treatment modalities and handling of clinical issues have been proposed after the publication. New approaches for editing clinical guidelines, such as the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system, also have been introduced for better and clearer grading of recommendations. Methods Clinical questions (CQs) were proposed in seven topics. Recommendation, grade of recommendation and statement for each CQ were discussed and finalized by evidencebased approach. Recommendation was graded to grade 1 (strong) and 2 (weak) according to the concept of GRADE system. Results The 29 CQs covered seven topics: (1) prophylactic treatment, (2) diagnosis, (3) biliary drainage, (4) surgical treatment, (5) chemotherapy, (6) radiation therapy, and (7) pathology. In 27 CQs, 19 recommendations were rated strong and 11 recommendations weak. Each CQ included the statement of how the recommendation was graded. Conclusions This guideline provides recommendation for important clinical aspects based on evidence. Future collaboration with cancer registry will be a key for assessment of the guidelines and establishment of new evidence. Free full-text articles and a mobile application of this guideline are available via

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Section: Cq16: What Are Considered As Unresectable Factors In Biliarymentioning

confidence: 97%

Clinical practice guidelines for the management of biliary tract cancers 2015: the 2^nd English edition

Miyazaki

Yoshitomi

Miyakawa³

et al. 2015

J Hepato Biliary Pancreat

237

165

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“…It is important to prevent spillage or implantation of malignant cells during LC. For pT2 or pT3 tumors diagnosed laparoscopically, a second or converted open radical surgery is mandatory [45]. Gallbladder perforation during LC has been associated with port site/ peritoneal recurrence and worse patient survival.…”

Section: What Is Incidental Gbc?mentioning

confidence: 99%

Management of cancer gallbladder found as a surprise on a resected gallbladder specimen

Misra

Guleria

2006

Journal of Surgical Oncology

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Carcinoma gallbladder is associated with an overall 5-year survival rate reported less than 5% due to late diagnosis. Advent of ultrasound scanning may help in detecting gallbladder polyps and an early gallbladder cancer. Excellent 5-year survival (up to 100%) has been reported for Stage Ia disease and the survival has significantly improved for Stage Ib, II, and III if appropriate re-operation is carried out soon after the incidental detection of gallbladder cancer. Laparoscopic cholecystectomy (LC) is contraindicated in the presence of gallbladder cancer. It is recommended to excise all laparoscopic port sites, at the time of re-operation. Re-operation for Stage II gallbladder cancer is associated with a 90-100% 3-year survival rate. Patients with Stage III and IV tumors also benefit from an extended cholecystectomy. Patients with bulky primary tumors without lymph node metastases (T4N0) seem to have a better prognosis than those with distant lymph node metastases, and should be treated aggressively. It is advantageous to perform the appropriate extent of surgery for gallbladder cancer at the initial operation. Heightened awareness of the presence of cancer and the knowledge of appropriate management are important. For patients whose cancer is an incidental finding on pathologic review, re-resection is indicated for all disease except Stage Ia. Radiotherapy and chemotherapy have not been found effective as an adjuvant or palliative therapy in gallbladder cancer.

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“…For pT2 or more advanced tumors, many authors advocate radical resection with lymph node dissection [10][11][12][13][14] . Previous reports have shown a second radical resection to be associated with significantly better survival than cholecystectomy alone in pT2 GBCa patients whose cancers were incidentally found after cholecystectomy [15][16][17][18] , whereas, Wakai et al [19] have reported that 40.5% of patients with unapparent pT2 tumors survived > 5 years after cholecystectomy alone. S4a5 hepatectomy combined with extra-hepatic bile duct resection (BDR) and D2 lymph node dissection is a highly recommended operation for the treatment of T2 and T3 GBCa [6] , although, in T2 GBCa, the surgical procedure remains controversial, and there is no standard operation.…”

Section: Introductionmentioning

confidence: 96%

Rational therapeutic strategy for T2 gallbladder carcinoma based on tumor spread

Kohya

Kono²,

Miyazaki

2010

WJG

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AIM:To evaluate the adequacy of surgical treatment of T2 gallbladder carcinoma (GBCa) according to tumor spread in the subserosal layer. METHODS:A series of 84 patients with GBCa were treated at Saga University Hospital, Japan between April 1989 and October 2008. The tumor stage was graded according to the TNM staging for GBCa from the American Joint Committee on Cancer Manual 6th edition. Tumor staging revealed 30 patients with T2 tumors. T2 GBCa was divided into three groups histologically by the extent of tumor spread in the subserosal layer, using a score of ss minimum (ss min), ss medium (ss med) or ss massive (ss mas). RESULTS:For ss min GBCa, there was no positive pathological factor and patient survival was satisfactory with simple cholecystectomy, with or without extra-hepatic bile duct resection. For ss med GBCa, some pathological factors, h-inf (hepatic infiltration), ly (lymphatic invasion) and n (lymph node metastasis), were positive. For ss mas GBCa, there was a high incidence of positive pathological factors. The patient group with extra-hepatic bile duct resection with D2 lymph node dissection (BDR with D2) and those with S4a5 hepatectomy had significantly better survival rates. CONCLUSION:We suggest that radical surgery is not necessary for ss min GBCa, and partial hepatectomy and BDR are necessary for both ss med and ss mas GBCa.

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Laparoscopic cholecystectomy in the treatment of patients with gallbladder cancer1

Cited by 42 publications

References 20 publications

Clinical practice guidelines for the management of biliary tract cancers 2015: the 2^nd English edition

Clinical practice guidelines for the management of biliary tract cancers 2015: the 2^nd English edition

Management of cancer gallbladder found as a surprise on a resected gallbladder specimen

Rational therapeutic strategy for T2 gallbladder carcinoma based on tumor spread

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Laparoscopic cholecystectomy in the treatment of patients with gallbladder cancer1

Cited by 42 publications

References 20 publications

Clinical practice guidelines for the management of biliary tract cancers 2015: the 2nd English edition

Clinical practice guidelines for the management of biliary tract cancers 2015: the 2nd English edition

Management of cancer gallbladder found as a surprise on a resected gallbladder specimen

Rational therapeutic strategy for T2 gallbladder carcinoma based on tumor spread

Contact Info

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Clinical practice guidelines for the management of biliary tract cancers 2015: the 2^nd English edition

Clinical practice guidelines for the management of biliary tract cancers 2015: the 2^nd English edition