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Erschienen in: World Journal of Surgery 8/2018

08.03.2018 | Original Scientific Report

Totally Laparoscopic Radical Resection of Gallbladder Cancer: Technical Aspects and Long-Term Results

verfasst von: César Muñoz Castro, Sergio Pacheco Santibañez, Tomás Contreras Rivas, Nicolás Jarufe Cassis

Erschienen in: World Journal of Surgery | Ausgabe 8/2018

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Abstract

Introduction

Gallbladder cancer (GBC) is a rare tumor in developed countries. Chile has one of the highest incidences worldwide. For patients affected by resectable T1b or more advanced GBC, radical cholecystectomy (RC) is considered the standard therapy. Our aim is to describe the surgical technique and clinical–pathological results of patients undergoing totally laparoscopic radical resection of GBC.

Methods

Patients undergo laparoscopic radical resection for primary and incidental GBC, between the years 2009 and 2016 in two centers from Chile. Patients in whom suspected bile duct invasion, frozen biopsy did not confirm cancer and para-aortic lymph node sampling was positive were excluded.

Results

Eighteen patients were operated, 77.8% were female with median age of 60.5 year, and 16 patients had previous cholecystectomy with incidental cancer finding. The median operative time was 490 min (400–550). No conversion to open surgery occurred. All patients achieved a R0 resection. Postoperative complications occurred in 2 patients (11.1%), and there was not mortality. After a median follow-up of 59 months, the 5-year survival was 80.7%.

Conclusion

This study shows the technical feasibility of the totally laparoscopic approach for radical resection of GBC with the same principles of classical open surgery. It appears that long-term oncological findings would also be similar at least in less advanced lesions.
Literatur
1.
Zurück zum Zitat Eslick GD (2010) Epidemiology of gallbladder cancer. Gastroenterol Clin North Am 39:307–330 Eslick GD (2010) Epidemiology of gallbladder cancer. Gastroenterol Clin North Am  39:307–330
2.
Zurück zum Zitat Roa I, Ibacache G, Muñoz S, De Aretxabala X (2014) Gallbladder cancer in Chile: pathologic characteristics of survival and prognostic factors: analysis of 1,366 cases. Am J Clin Pathol 141(5):675–682CrossRefPubMed Roa I, Ibacache G, Muñoz S, De Aretxabala X (2014) Gallbladder cancer in Chile: pathologic characteristics of survival and prognostic factors: analysis of 1,366 cases. Am J Clin Pathol 141(5):675–682CrossRefPubMed
3.
Zurück zum Zitat Hibi T, Cherqui D, Geller DA, Itano O, Kitagawa Y, Wakabayashi G (2014) International survey on technical aspects of laparoscopic liver resection: a web-based study on the global diffusion of laparoscopic liver surgery prior to the 2nd international consensus conference on laparoscopic liver resection in Iwate, Japan. J Hepatobiliary Pancreat Sci 21:737–744CrossRefPubMed Hibi T, Cherqui D, Geller DA, Itano O, Kitagawa Y, Wakabayashi G (2014) International survey on technical aspects of laparoscopic liver resection: a web-based study on the global diffusion of laparoscopic liver surgery prior to the 2nd international consensus conference on laparoscopic liver resection in Iwate, Japan. J Hepatobiliary Pancreat Sci 21:737–744CrossRefPubMed
4.
Zurück zum Zitat Goumard C, Farges O, Laurent A, Cherqui D, Soubrane O, Gayet B et al (2015) An update on laparoscopic liver resection: the French Hepato-Bilio-Pancreatic Surgery Association statement. J Visc Surg 152(2):107–112CrossRefPubMed Goumard C, Farges O, Laurent A, Cherqui D, Soubrane O, Gayet B et al (2015) An update on laparoscopic liver resection: the French Hepato-Bilio-Pancreatic Surgery Association statement. J Visc Surg 152(2):107–112CrossRefPubMed
5.
Zurück zum Zitat Nguyen KT, Gamblin TC, Geller DA (2009) World review of laparoscopic liver resection 2,804 patients. Ann Surg 250(5):831–841CrossRefPubMed Nguyen KT, Gamblin TC, Geller DA (2009) World review of laparoscopic liver resection 2,804 patients. Ann Surg 250(5):831–841CrossRefPubMed
6.
Zurück zum Zitat Goetze TO, Paolucci V (2014) Die unmittelbare radikale Re-Operation bei inzidentellem T1b-Gallenblasenkarzinom und die Frage der angemessenen Radikalität (CAES-/-CAMIC-Zentralregister: “okkultes Gallenblasenkarzinom”). Zentralbl Chir 139:e43–e48CrossRefPubMed Goetze TO, Paolucci V (2014) Die unmittelbare radikale Re-Operation bei inzidentellem T1b-Gallenblasenkarzinom und die Frage der angemessenen Radikalität (CAES-/-CAMIC-Zentralregister: “okkultes Gallenblasenkarzinom”). Zentralbl Chir 139:e43–e48CrossRefPubMed
7.
Zurück zum Zitat Horiguchi A, Miyakawa S, Ishihara S, Miyazaki M, Ohtsuka M, Shimizu H et al (2013) 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. 20(5):518–524CrossRefPubMed Horiguchi A, Miyakawa S, Ishihara S, Miyazaki M, Ohtsuka M, Shimizu H et al (2013) 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. 20(5):518–524CrossRefPubMed
8.
Zurück zum Zitat Kondo S, Nimura Y, Hayakawa N, Kamiya J, Nagino M, Uesaka K (2000) Regional and para-aortic lymphadenectomy in radical surgery for advanced gallbladder carcinoma. Br J Surg 87(4):418–422CrossRefPubMed Kondo S, Nimura Y, Hayakawa N, Kamiya J, Nagino M, Uesaka K (2000) Regional and para-aortic lymphadenectomy in radical surgery for advanced gallbladder carcinoma. Br J Surg 87(4):418–422CrossRefPubMed
9.
Zurück zum Zitat Aloia TA, Járufe N, Javle M, Maithel SK, Roa JC, Adsay V et al (2015) Gallbladder cancer: expert consensus statement. HPB (Oxford). 17(8):681–690CrossRefPubMedPubMedCentral Aloia TA, Járufe N, Javle M, Maithel SK, Roa JC, Adsay V et al (2015) Gallbladder cancer: expert consensus statement. HPB (Oxford). 17(8):681–690CrossRefPubMedPubMedCentral
10.
Zurück zum Zitat Liu G, Li X, Chen Y, Sun H, Zhao G, Hu S (2013) Radical lymph node dissection and assessment: Impact on gallbladder cancer prognosis. World J Gastroenterol 19(31):5150–5158CrossRefPubMedPubMedCentral Liu G, Li X, Chen Y, Sun H, Zhao G, Hu S (2013) Radical lymph node dissection and assessment: Impact on gallbladder cancer prognosis. World J Gastroenterol 19(31):5150–5158CrossRefPubMedPubMedCentral
11.
Zurück zum Zitat Goetze TO, Paolucci V (2010) Adequate extent in radical re-resection of incidental gallbladder carcinoma: analysis of the German registry. Surg Endosc 24(9):2156–2164CrossRefPubMed Goetze TO, Paolucci V (2010) Adequate extent in radical re-resection of incidental gallbladder carcinoma: analysis of the German registry. Surg Endosc 24(9):2156–2164CrossRefPubMed
12.
Zurück zum Zitat Shirai Y, Sakata J, Wakai T, Ohashi T, Ajioka Y, Hatakeyama K (2012) Assessment of lymph node status in gallbladder cancer: location, number, or ratio of positive nodes. World J Surg Oncol 10(87):87CrossRefPubMedPubMedCentral Shirai Y, Sakata J, Wakai T, Ohashi T, Ajioka Y, Hatakeyama K (2012) Assessment of lymph node status in gallbladder cancer: location, number, or ratio of positive nodes. World J Surg Oncol 10(87):87CrossRefPubMedPubMedCentral
13.
Zurück zum Zitat Agarwal AK, Javed A, Kalayarasan R, Sakhuja P (2015) Minimally invasive versus the conventional open surgical approach of a radical cholecystectomy for gallbladder cancer: a retrospective comparative study. HPB (Oxford) 17(6):536–541CrossRef Agarwal AK, Javed A, Kalayarasan R, Sakhuja P (2015) Minimally invasive versus the conventional open surgical approach of a radical cholecystectomy for gallbladder cancer: a retrospective comparative study. HPB (Oxford) 17(6):536–541CrossRef
14.
Zurück zum Zitat Gumbs AA, Hoffman JP (2010) Laparoscopic completion radical cholecystectomy for T2 gallbladder cancer. Surg Endosc 24(12):3221–3223CrossRefPubMed Gumbs AA, Hoffman JP (2010) Laparoscopic completion radical cholecystectomy for T2 gallbladder cancer. Surg Endosc 24(12):3221–3223CrossRefPubMed
15.
Zurück zum Zitat Gumbs AA, Hoffman JP (2010) Laparoscopic radical cholecystectomy and Roux-en-Y choledochojejunostomy for gallbladder cancer. Surg Endosc 24(7):1766–1768CrossRefPubMed Gumbs AA, Hoffman JP (2010) Laparoscopic radical cholecystectomy and Roux-en-Y choledochojejunostomy for gallbladder cancer. Surg Endosc 24(7):1766–1768CrossRefPubMed
16.
Zurück zum Zitat Cho JY, Han H-S, Yoon Y-S, Ahn KS, Kim Y-H, Lee K-H (2010) Laparoscopic approach for suspected early-stage gallbladder carcinoma. Arch Surg 145(2):128–133CrossRefPubMed Cho JY, Han H-S, Yoon Y-S, Ahn KS, Kim Y-H, Lee K-H (2010) Laparoscopic approach for suspected early-stage gallbladder carcinoma. Arch Surg 145(2):128–133CrossRefPubMed
17.
Zurück zum Zitat Gumbs AA, Jarufe N, Gayet B (2013) Minimally invasive approaches to extrapancreatic cholangiocarcinoma. Surg Endosc 27(2):406–414CrossRefPubMed Gumbs AA, Jarufe N, Gayet B (2013) Minimally invasive approaches to extrapancreatic cholangiocarcinoma. Surg Endosc 27(2):406–414CrossRefPubMed
19.
Zurück zum Zitat Esterio IR, González PG, Gilda TM, Suárez I, Oróstica JA, Hernández MV et al (2004) Cáncer de la vesícula biliar en colecistectomías por litiasis. Rev Esp Patol 37(3):279–285 Esterio IR, González PG, Gilda TM, Suárez I, Oróstica JA, Hernández MV et al (2004) Cáncer de la vesícula biliar en colecistectomías por litiasis. Rev Esp Patol 37(3):279–285
20.
Zurück zum Zitat Fuks D, Regimbeau J, Pessaux P, Bachellier P, Raventos A, Mantion G et al (2013) Is port-site resection necessary in the surgical management of gallbladder cancer ? J Visc Surg 150(4):277–284CrossRefPubMed Fuks D, Regimbeau J, Pessaux P, Bachellier P, Raventos A, Mantion G et al (2013) Is port-site resection necessary in the surgical management of gallbladder cancer ? J Visc Surg 150(4):277–284CrossRefPubMed
21.
Zurück zum Zitat Maker A, Butte J, Oxenberg J, Kuk D, Gonen M, Fong Y et al (2012) Is port site resection necessary in the surgical management of gallbladder cancer? Ann Surg Oncol 19(2):409–417CrossRefPubMed Maker A, Butte J, Oxenberg J, Kuk D, Gonen M, Fong Y et al (2012) Is port site resection necessary in the surgical management of gallbladder cancer? Ann Surg Oncol 19(2):409–417CrossRefPubMed
22.
Zurück zum Zitat Jin K, Lan H, Zhu T, He K, Teng L (2011) Gallbladder carcinoma incidentally encountered during laparoscopic cholecystectomy: how to deal with it. Clin Transl Oncol 13(1):25–33CrossRefPubMed Jin K, Lan H, Zhu T, He K, Teng L (2011) Gallbladder carcinoma incidentally encountered during laparoscopic cholecystectomy: how to deal with it. Clin Transl Oncol 13(1):25–33CrossRefPubMed
23.
Zurück zum Zitat Misra MC, Guleria S (2006) Management of cancer gallbladder found as a surprise on a resected gallbladder specimen. J Surg Oncol 93(8):690–698CrossRefPubMed Misra MC, Guleria S (2006) Management of cancer gallbladder found as a surprise on a resected gallbladder specimen. J Surg Oncol 93(8):690–698CrossRefPubMed
24.
Zurück zum Zitat Agarwal AK, Kalayarasan R, Javed A, Gupta N, Nag HH (2013) 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 258(2):318–323CrossRefPubMed Agarwal AK, Kalayarasan R, Javed A, Gupta N, Nag HH (2013) 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 258(2):318–323CrossRefPubMed
25.
Zurück zum Zitat Palanisamy S, Patel N, Sabnis S, Palanisamy N, Vijay A, Palanivelu P et al (2015) Laparoscopic radical cholecystectomy for suspected early gall bladder carcinoma: thinking beyond convention. Surg Endosc 30(6):2442–2448CrossRefPubMed Palanisamy S, Patel N, Sabnis S, Palanisamy N, Vijay A, Palanivelu P et al (2015) Laparoscopic radical cholecystectomy for suspected early gall bladder carcinoma: thinking beyond convention. Surg Endosc 30(6):2442–2448CrossRefPubMed
26.
Zurück zum Zitat Shirobe T, Maruyama S (2015) Laparoscopic radical cholecystectomy with lymph node dissection for gallbladder carcinoma. Surg Endosc 29(8):2244–2250CrossRefPubMed Shirobe T, Maruyama S (2015) Laparoscopic radical cholecystectomy with lymph node dissection for gallbladder carcinoma. Surg Endosc 29(8):2244–2250CrossRefPubMed
Metadaten
Titel
Totally Laparoscopic Radical Resection of Gallbladder Cancer: Technical Aspects and Long-Term Results
verfasst von
César Muñoz Castro
Sergio Pacheco Santibañez
Tomás Contreras Rivas
Nicolás Jarufe Cassis
Publikationsdatum
08.03.2018
Verlag
Springer International Publishing
Erschienen in
World Journal of Surgery / Ausgabe 8/2018
Print ISSN: 0364-2313
Elektronische ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-018-4490-4

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