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 21 April 2018

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News

Does laparoscopic surgery have a role in the treatment of gallbladder cancer?

When a polypoid lesion of the gallbladder is found laparoscopic surgery may be attempted initially, finds a team of researchers from Korea.

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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."

J Hepatobiliary Pancreat Surg 2002; 9(5): 559-63
24 January 2003

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