Gallbladder Cancer: Role of Laparoscopy in the Management of Potentially Resectable Tumors

Overview

Journal Surg Endosc

Publisher Springer

Specialties Gastroenterology
General Surgery
Radiology

Date 2010 Feb 24

PMID 20177932

Citations 12

Authors

Xabier de Aretxabala

Jorge Leon

Juan Hepp

Fernando Maluenda

Ivan Roa

Affiliations

Soon will be listed here.

Abstract

Background: The aim of this study was to evaluate the role that laparoscopy plays in the management of gallbladder cancer.

Method: From August 2005 to March 2009, 23 patients affected by gallbladder cancer detected after the study of a cholecystectomy specimen underwent laparoscopy as part of their management.

Results: Among the patients, 5 underwent only an exploratory laparoscopy, while 11 were converted due to the existence of dense adhesions that precluded a complete exploration. Of the patients with adhesions who underwent conversion, three were unresectable. The remainder underwent a lymphadenectomy and liver resection after conversion. Of the seven who underwent a complete laparoscopic exploration, five had a lymphadenectomy and liver resection done completely by laparoscopy while conversion was needed for two. Conversion was required due to lymphatic metastasis at the hepatic pedicle and the presence of a bile leak. Postoperative time was uneventful, with patients discharged within 3 days of the operation.

Conclusions: Laparoscopy may be employed in the management of patients with early forms of gallbladder cancer undergoing reoperation. Although the presence of adhesions may result in inadequate exploration, there is a subset of patients for whom it is possible to perform a complete exam. Furthermore, laparoscopic lymphadenectomy and gallbladder bed resection is a promising technique in well-selected patients.

Citing Articles

Benchmarks and Geographic Differences in Gallbladder Cancer Surgery: An International Multicenter Study.

Vega E, Newhook T, Mellado S, Ruzzenente A, Okuno M, De Bellis M Ann Surg Oncol. 2023; 30(8):4904-4911.

PMID: 37149547 PMC: 11830408. DOI: 10.1245/s10434-023-13531-2.

Oncologic and Long-Term Outcomes of Laparoscopic and Open Extended Cholecystectomy for Gallbladder Cancer.

Lee J, Kwon J, Lee J J Clin Med. 2022; 11(8).

PMID: 35456227 PMC: 9027168. DOI: 10.3390/jcm11082132.

Treatment of Resectable Gallbladder Cancer.

Vega E, Mellado S, Salehi O, Freeman R, Conrad C Cancers (Basel). 2022; 14(6).

PMID: 35326566 PMC: 8945892. DOI: 10.3390/cancers14061413.

Oncologic safety of laparoscopic radical cholecystectomy in pT2 gallbladder cancer: A propensity score matching analysis compared to open approach.

Navarro J, Kang I, Hwang H, Yoon D, Lee W, Kang C Medicine (Baltimore). 2020; 99(20):e20039.

PMID: 32443308 PMC: 7253605. DOI: 10.1097/MD.0000000000020039.

Comparison of oncological outcomes after open and laparoscopic re-resection of incidental gallbladder cancer.

Vega E, De Aretxabala X, Qiao W, Newhook T, Okuno M, Castillo F Br J Surg. 2019; 107(3):289-300.

PMID: 31873948 PMC: 11844344. DOI: 10.1002/bjs.11379.

References

Nelson H, Sargent D, Wieand H, Fleshman J, Anvari M, Stryker S . A comparison of laparoscopically assisted and open colectomy for colon cancer. N Engl J Med. 2004; 350(20):2050-9. DOI: 10.1056/NEJMoa032651. View

Gagner M, Rogula T, Selzer D . Laparoscopic liver resection: benefits and controversies. Surg Clin North Am. 2004; 84(2):451-62. DOI: 10.1016/j.suc.2003.11.002. View

Zgraggen K, Birrer S, Maurer C, Wehrli H, Klaiber C, Baer H . Incidence of port site recurrence after laparoscopic cholecystectomy for preoperatively unsuspected gallbladder carcinoma. Surgery. 1998; 124(5):831-8. View

Troisi R, Montalti R, Smeets P, Van Huysse J, Van Vlierberghe H, Colle I . The value of laparoscopic liver surgery for solid benign hepatic tumors. Surg Endosc. 2007; 22(1):38-44. DOI: 10.1007/s00464-007-9527-y. View

Ng K, Ng D, Cheung H, Wong J, Yau K, Chung C . Laparoscopic resection for rectal cancers: lessons learned from 579 cases. Ann Surg. 2008; 249(1):82-6. DOI: 10.1097/SLA.0b013e31818e418a. View

Vibert E, Perniceni T, Levard H, Denet C, Shahri N, Gayet B . Laparoscopic liver resection. Br J Surg. 2005; 93(1):67-72. DOI: 10.1002/bjs.5150. View

Wistuba I, Gazdar A . Gallbladder cancer: lessons from a rare tumour. Nat Rev Cancer. 2004; 4(9):695-706. DOI: 10.1038/nrc1429. View

Andia K M, Gederlini G A, Ferreccio R C . [Gallbladder cancer: trend and risk distribution in Chile]. Rev Med Chil. 2006; 134(5):565-74. DOI: 10.4067/s0034-98872006000500004. View

Buell J, Koffron A, Thomas M, Rudich S, Abecassis M, Woodle E . Laparoscopic liver resection. J Am Coll Surg. 2005; 200(3):472-80. DOI: 10.1016/j.jamcollsurg.2004.10.017. View

10.

Dixon E, Vollmer Jr C, Sahajpal A, Cattral M, Grant D, Doig C . An aggressive surgical approach leads to improved survival in patients with gallbladder cancer: a 12-year study at a North American Center. Ann Surg. 2005; 241(3):385-94. PMC: 1356976. DOI: 10.1097/01.sla.0000154118.07704.ef. View

11.

Schaeff B, Paolucci V, Thomopoulos J . Port site recurrences after laparoscopic surgery. A review. Dig Surg. 1998; 15(2):124-34. DOI: 10.1159/000018605. View

12.

Gagner M, Pomp A . Laparoscopic pylorus-preserving pancreatoduodenectomy. Surg Endosc. 1994; 8(5):408-10. DOI: 10.1007/BF00642443. View

13.

Mala T, Edwin B . Role and limitations of laparoscopic liver resection of colorectal metastases. Dig Dis. 2005; 23(2):142-50. DOI: 10.1159/000088596. View

14.

Shirai Y, Yoshida K, Tsukada K, Muto T . Inapparent carcinoma of the gallbladder. An appraisal of a radical second operation after simple cholecystectomy. Ann Surg. 1992; 215(4):326-31. PMC: 1242447. DOI: 10.1097/00000658-199204000-00004. View

15.

de Aretxabala X, Roa I, Burgos L, Losada H, Roa J, Mora J . Gallbladder cancer: an analysis of a series of 139 patients with invasion restricted to the subserosal layer. J Gastrointest Surg. 2006; 10(2):186-92. DOI: 10.1016/j.gassur.2005.11.003. View

16.

Ohmura Y, Yokoyama N, Tanada M, Takiyama W, Takashima S . Port site recurrence of unexpected gallbladder carcinoma after a laparoscopic cholecystectomy: report of a case. Surg Today. 1999; 29(1):71-5. DOI: 10.1007/BF02482974. View

17.

You D, Lee H, Paik K, Heo J, Choi S, Choi D . What is an adequate extent of resection for T1 gallbladder cancers?. Ann Surg. 2008; 247(5):835-8. DOI: 10.1097/SLA.0b013e3181675842. View

18.

Palanivelu C, Jani K, Senthilnathan P, Parthasarathi R, Rajapandian S, Madhankumar M . Laparoscopic pancreaticoduodenectomy: technique and outcomes. J Am Coll Surg. 2007; 205(2):222-30. DOI: 10.1016/j.jamcollsurg.2007.04.004. View

19.

Wakai T, Shirai Y, Yokoyama N, Nagakura S, Watanabe H, Hatakeyama K . Early gallbladder carcinoma does not warrant radical resection. Br J Surg. 2001; 88(5):675-8. DOI: 10.1046/j.1365-2168.2001.01749.x. View

20.

Lanthaler M, Freund M, Nehoda H . Laparoscopic resection of a giant liver hemangioma. J Laparoendosc Adv Surg Tech A. 2005; 15(6):624-6. DOI: 10.1089/lap.2005.15.624. View