Outcomes after Combined Laparoscopic Gastrectomy and Laparoscopic Cholecystectomy in Gastric Cancer Patients

Abstract

Background/Aims: The purpose of this study was to determine the effect of performing laparoscopic cholecystectomy on patients undergoing laparoscopic-assisted gastrectomy for gastric cancer. Methods: This single center study involved a retrospective review of a database of 400 patients who underwent consecutive laparoscopic-assisted gastrectomy for early gastric cancer from June 2003 to July 2007. Outcomes in 26 patients who underwent both laparoscopic-assisted gastrectomy and laparoscopic cholecystectomy were compared with outcomes from 364 patients who underwent laparoscopic-assisted gastrectomy without laparoscopic cholecystectomy. Results: There were no postoperative 30-day mortalities in the combined cholecystectomy group. The mean surgery duration, time to first flatus and postoperative hospital stay for the laparoscopic gastric resection without combined operation were 181.7 min, 2.7 days and 9.7 days, respectively, and 196.7 min, 2.6 days and 8.8 days, respectively, for the combined cholecystectomy group. None of the postoperative complications was related to combined cholecystectomy. Conclusion: Performing a combined cholecystectomy prolonged the mean surgery duration by approximately 15 min, but had no effect on surgical outcomes. It appears that performing a cholecystectomy at the same time as laparoscopic gastric resection is safe and feasible in patients with both early gastric cancer and gallbladder disease.

Laparoscopic Gastrectomy for Gastric Cancer with Simultaneous Organ Resection

“…21,22 Increasing numbers of surgeons have applied laparoscopic techniques to simultaneous organ resection. Hiratsuka et al 11 and Jeong et al 5 reported positive clinical results after simultaneous LG and cholecystectomy. In the study by Hiratsuka et al, 11 the clinical outcomes of 7 cases were reported, and only 1 case showed surgical complications.…”

“…In the study by Hiratsuka et al, 11 the clinical outcomes of 7 cases were reported, and only 1 case showed surgical complications. Jeong et al 5 compared the outcomes of 26 patients undergoing concomitant operation with those of 364 patients who received only LG and showed that concomitant cholecystectomy was not associated with morbidity. However, these studies did not address the outcome of simultaneous operation in cases of severe disease.…”

“…Furthermore, the detection of other pathologic conditions requiring simultaneous surgery has recently increased as a consequence of health screening programs and the development of diagnostic tools. 4,5 Simultaneous organ resection is performed in 10.1% of gastric cancers, as reported by Park et al, 6 and Ozer et al 7 reported a rate of 7.7%. However, many studies have reported that simultaneous organ resection, which is commonly performed in daily clinical practice, was associated with prolonged postoperative recovery and increased morbidity and mortality.…”

“…[6][7][8][9][10] After the introduction of laparoscopic surgery in the 1990s, several studies reassessed the effects of simultaneous organ resection in a laparoscopic setting. 4,5,8,[11][12][13][14] However, most studies were limited by a small sample size and the inclusion of relatively less involved cases. Here, we reviewed our data to evaluate the feasibility and safety of laparoscopic simultaneous organ resection during laparoscopic radical gastrectomy for gastric cancer.…”

Successful cholecystectomy during robotic gastrectomy

“…The clinical decision to treat cholelithiasis at the time of gastrectomy for gastric cancer is largely due to the high incidence of post-gastrectomy symptomatic gallbladder disease, which may affect 25% of such patients (20,21). In fact, laparoscopic gastrectomy has been successfully combined with cholecystectomy with minimal additional operative time and no increased morbidity (22).…”