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Laparoscopic cholecystectomy and gallbladder cancer
Author(s) -
Steinert Ralf,
Nestler Gerd,
Sagynaliev Emil,
Müller Jörg,
Lippert Hans,
Reymond MarcAndré
Publication year - 2006
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.20536
Subject(s) - medicine , cholecystectomy , lymphadenectomy , gallbladder cancer , general surgery , gallbladder , radical surgery , laparoscopic cholecystectomy , incidence (geometry) , port (circuit theory) , surgery , cancer , physics , electrical engineering , optics , engineering
Abstract Heightened awareness of the possible presence of gallbladder cancer (GBC) and the knowledge of appropriate management are important for surgeons practising laparoscopic cholecystectomy (LC). Long‐term effects of initial LC versus open cholecystectomy (OC) on the prognosis of patients with GBC remain undefined. Patients who are suspected to have GBC should not undergo LC, since it is advantageous to perform the en‐bloc radical surgery at the initial operation. Since preoperative diagnosis of early GBC is difficult, preventive measures, such as preventing bile spillage and bagging the gallbladder should be applied for every LC. Many port‐site recurrences (PSR) have been reported after LC, but the incidence of wound recurrence is not higher than after OC. No radical procedure is required after postoperative diagnosis of incidental pT1a GBC. It is unclear if patients with pT1b GBC require extended cholecystectomy. In pT2 GBC, patients should have radical surgery (atypical or segmental liver resection and lymphadenectomy). In advanced GBC (pT3 and pT4), radical surgery can cure only a small subset of patients, if any. Additional port‐site excision is recommended, but the effectiveness of such measure is debated. J. Surg. Oncol. 2006;93:682–689. © 2006 Wiley‐Liss, Inc.