This study, published in the latest issue of the Journal of Hepato-Biliary-Pancreatic Surgery, evaluated the role of laparoscopic surgery in the treatment of gallbladder cancer.
The research team performed a retrospective study on 31 patients with a postoperative diagnosis of gallbladder cancer. The team initially applied a laparoscopic approach to all patients.
Of the 31, 10 patients had pT1a cancer. All underwent laparoscopic cholecystectomy without recurrence.
A further 9 patients had pT1b lesions, 3 of these had to be converted to an open operation. If these, there were 2 recurrences.
In 1 of the converted patients the cystic node was invaded.
|5-year survival rate was 100% for patients with pT1a cancer.|
|Journal of Hepato-Biliary-Pancreatic Surgery|
In addition, 7 patients had pT2 lesions. In 4 of these patients the operation was converted to an open procedure. Recurrences were observed in 3 patients.
However, in the 2 patients with pT3 cancer, the operations were converted. The cancer recurred in both patients.
The team found that only diagnostic laparoscopy, or a palliative laparoscopic procedure, were performed for pT4 cancers.
The median follow-up time was 17 months.
The research team calculated the 5-year survival rate to be 100% for patients with stage pT1a, 100% for pT1b, and 68% for pT2 lesions.
Dr Eung Kook Kim's team concluded, "We suggest that when a polypoid lesion of the gallbladder is found on preoperative evaluation, laparoscopic surgery may be attempted initially".
"During the procedure it is important to open all specimens when a polypoid lesion is present and perform a frozen section biopsy."
"When a pT1a lesion is found, laparoscopic cholecystectomy is sufficient; however, when a pT1b or more advanced lesion is found, the operation might be converted to a radical cholecystectomy."