Minimally invasive versus the conventional open surgical approach of a radical cholecystectomy for gallbladder cancer: a retrospective comparative study

Agarwal, Anil; Javed, Amit; Kalayarasan, Raja; Sakhuja, Puja

doi:10.1111/hpb.12406

Cited by 110 publications

(113 citation statements)

References 24 publications

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“…Despite limited experiences by experts, laparoscopic extended cholecystectomy has been shown to be safe and feasible in selected GBC patients, with similar results to those of open surgery [3, 5, 7-10, 18, 20-26]. According to published reports, the most commonly performed procedures are wedge liver resection and LN dissection.…”

Section: Resultsmentioning

confidence: 99%

“…Laparoscopic bile duct resection may be performed in cases with positive cystic duct margins or involvement of the bile duct by tumor. Laparoscopic IVb/V segmentectomy has been performed in some centers [5, 9, 25]. …”

Section: Resultsmentioning

confidence: 99%

“…Some centers additionally dissect LNs in the posterior superior pancreaticoduodenal area and along the common hepatic artery because of frequent LN metastasis in this area and improved patient survival if removed completely [27-29]. Recent reports have shown that LN dissection can be performed to the same extent in laparoscopic surgery as in the open procedure in selected GBC patients with few intraoperative and postoperative complications [3, 5, 7-10]. The number of retrieved LNs is comparable between laparoscopic and open surgeries.…”

Section: Resultsmentioning

confidence: 99%

“…No significant difference in survival rate between the 2 procedures has been reported. Recent reports on laparoscopic extended cholecystectomy for GBC have demonstrated the technical feasibility and safety of laparoscopic wedge resection, and the feasibility of laparoscopic IVb/V resection for GBC has also been reported [5, 9, 25]. …”

Section: Resultsmentioning

confidence: 99%

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Laparoscopic Surgery for Gallbladder Cancer: An Expert Consensus Statement

et al. 2018

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Background: Despite the increasing number of reports on the favorable outcomes of laparoscopic surgery for gallbladder cancer (GBC), there is no consensus regarding this surgical procedure. Objective: The study aimed to develop a consensus statement on the application of laparoscopic surgery for GBC based on expert opinions. Methods: A consensus meeting among experts was held on September 10, 2016, in Seoul, Korea. Results: Early concerns regarding port site/peritoneal metastasis after laparoscopic surgery have been abated by improved preoperative recognition of GBC and careful manipulation to avoid bile spillage. There is no evidence that laparoscopic surgery is associated with decreased survival compared with open surgery in patients with early-stage GBC if definitive resection during/after laparoscopic cholecystectomy is performed. Although experience with laparoscopic extended cholecystectomy for GBC has been limited to a few experts, the postoperative and survival outcomes were similar between laparoscopic and open surgeries. Laparoscopic reoperation for postoperatively diagnosed GBC is technically challenging, but its feasibility has been demonstrated by a few experts. Conclusions: Laparoscopic surgery for GBC is still in the early phase of the adoption curve, and more evidence is required to assess this procedure.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Laparoscopic Surgery for Gallbladder Cancer: An Expert Consensus Statement

et al. 2018

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“…Few groups have reported laparoscopic extended cholecystectomy (Agarwal 2015) and even laparoscopic bisegmentectomy (IVb+V) (Machado 2015) but results in the form of recurrence (especially port site metastases) and long term survival are awaited before it can be recommended. Yoon (2015) performed laparoscopic surgery (extended cholecystectomy=32, simple cholecystectomy=13) in 45 patients with suspected early GBC (T1=20, T2=25) and reported 5 year survival of 79%.…”

Section: Short Communicationmentioning

confidence: 99%

Peep Before You Enter – Laparoscopy in Gall Bladder Cancer

Kapoor¹

2017

J Gastrointest Cancer Stromal Tumor

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Gall bladder cancer (GBC) is the commonest biliary tract cancer worldwide. Clinically 'obvious' GBC is usually advanced; a careful search should be made for metastases. In the absence of clinical metastases, resectability should be assessed with CT; PET can complement CT in detecting metastases. Laparoscopy has been used for staging of pancreatic and hepato-biliary cancers. Staging laparoscopy is 'strongly recommended' before laparotomy in GBC; it should be performed in incidental GBC also before reoperation for completion extended cholecystectomy (CEC). Addition of US to laparoscopy can increase the yield and accuracy. Laparoscopic extended cholecystectomy has also been reported. We have described anticipatory extended cholecystectomy (AEC) for thick walled GB; it can also be performed laparoscopically.

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Systematic review of management of incidental gallbladder cancer after cholecystectomy

Søreide

Guest

Harrison

et al. 2019

Journal of British Surgery

112

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Background Gallbladder cancer is rare, but cancers detected incidentally after cholecystectomy are increasing. The aim of this study was to review the available data for current best practice for optimal management of incidental gallbladder cancer. Methods A systematic PubMed search of the English literature to May 2018 was conducted. Results The search identified 12 systematic reviews and meta‐analyses, in addition to several consensus reports, multi‐institutional series and national audits. Some 0·25–0·89 per cent of all cholecystectomy specimens had incidental gallbladder cancer on pathological examination. Most patients were staged with pT2 (about half) or pT1 (about one‐third) cancers. Patients with cancers confined to the mucosa (T1a or less) had 5‐year survival rates of up to 100 per cent after cholecystectomy alone. For cancers invading the muscle layer of the gallbladder wall (T1b or above), reresection is recommended. The type, extent and timing of reresection remain controversial. Observation time may be used for new cross‐sectional imaging with CT and MRI. Perforation at initial surgery had a higher risk of disease dissemination. Gallbladder cancers are PET‐avid, and PET may detect residual disease and thus prevent unnecessary surgery. Routine laparoscopic staging before reresection is not warranted for all stages. Risk of peritoneal carcinomatosis increases with each T category. The incidence of port‐site metastases is about 10 per cent. Routine resection of port sites has no effect on survival. Adjuvant chemotherapy is poorly documented and probably underused. Conclusion Management of incidental gallbladder cancer continues to evolve, with more refined suggestions for subgroups at risk and a selective approach to reresection.

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Minimally invasive versus the conventional open surgical approach of a radical cholecystectomy for gallbladder cancer: a retrospective comparative study

Abstract: LRC is safe and feasible in selected patients with GBC, and the results were comparable to ORC in this retrospective comparison.

Cited by 110 publications

References 24 publications

Laparoscopic Surgery for Gallbladder Cancer: An Expert Consensus Statement

Laparoscopic Surgery for Gallbladder Cancer: An Expert Consensus Statement

Peep Before You Enter – Laparoscopy in Gall Bladder Cancer

Systematic review of management of incidental gallbladder cancer after cholecystectomy

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