Is Laparoscopy Contraindicated for Gallbladder Cancer? A 10-Year Prospective Cohort Study
- 1 October 2015
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Journal of the American College of Surgeons
- Vol. 221 (4), 847-853
- https://doi.org/10.1016/j.jamcollsurg.2015.07.010
Abstract
Laparoscopic treatment for gallbladder cancer (GBC) has long been contraindicated, but few studies have demonstrated the oncologic outcomes of this treatment. The purpose of this study was to evaluate long-term survival after intended laparoscopic surgery for early-stage GBC based on our 10 years of experience. Between May 2004 and April 2014, eighty-three patients suspected of having early-stage GBC with no evidence of liver invasion were enrolled in the prospective protocol for laparoscopic surgery. Data for 45 of these patients with pathologically proven GBC were analyzed to determine the safety and oncologic outcomes of a laparoscopic approach to GBC. Twenty-six patients whose postoperative follow-up exceeded 5 years were investigated to determine the 5-year actual survival outcomes. Extended cholecystectomy, including laparoscopic lymphadenectomy, was performed in 32 patients and simple cholecystectomy in 13 patients. The T stages based on final pathologic results were Tis (n = 2), T1a (n = 10), T1b (n = 8), and T2 (n = 25). After a median follow-up of 60 months after surgery, recurrence was detected in 4 patients as distant metastases. There was no local recurrence around the gallbladder bed or lymphadenectomy. Disease-specific 5-year survival rate of the 45 patients was 94.2%. Disease-specific actual survival rate of 26 patients whose postoperative follow-up period exceeded 5 years was 92.3% at 5 years. The favorable long-term oncologic results shown in this study confirm the oncologic safety of laparoscopic cholecystectomy, including laparoscopic lymphadenectomy in selected patients with GBC.Keywords
This publication has 31 references indexed in Scilit:
- Open versus laparoscopically-assisted oesophagectomy for cancer: a multicentre randomised controlled phase III trial - the MIRO trialBMC Cancer, 2011
- Systematic review on the surgical treatment for T1 gallbladder cancerWorld Journal of Gastroenterology, 2011
- Recurrence Following Laparoscopy-Assisted Gastrectomy for Gastric Cancer: A Multicenter Retrospective Analysis of 1,417 PatientsAnnals of Surgical Oncology, 2010
- Surgical Treatment of pT2 Gallbladder Carcinoma: A Reevaluation of the Therapeutic Effect of Hepatectomy and Extrahepatic Bile Duct Resection Based on the Long-term OutcomeAnnals of Surgical Oncology, 2007
- Laparoscopic cholecystectomy for early gallbladder carcinoma: long-term outcome in comparison with conventional open cholecystectomySurgical Endoscopy, 2006
- Laparoscopic cholecystectomy and gallbladder cancerJournal of Surgical Oncology, 2006
- Does laparoscopy worsen the prognosis for incidental gallbladder cancer?Surgical Endoscopy, 2005
- Laparoscopic Staging in Gallbladder CancerDigestive Surgery, 2005
- Should Suspected Early Gallbladder Cancer Be Treated Laparoscopically?Journal of Gastrointestinal Surgery, 2002
- Surgical Treatment of Patients with T2 Gallbladder Carcinoma Invading The Subserosal LayerJournal of the American College of Surgeons, 2001