In this study, investigators from Chile and the United States compared the survival rate of patients undergoing a laparoscopic cholecystectomy with those undergoing an open operation.
The team assessed 24 patients with gallbladder cancer detected after laparoscopic cholecystectomy and 40 patients with cancer detected after open cholecystectomy.
The laparoscopic series included 2 patients with in situ tumors, 2 with mucosal tumors, 1 with muscular invasion, 13 with subserosal invasion, and 6 with serosal invasion. The team found recurrences in 4 of the 10 patients with subserosal compromise who underwent reoperation.
In the open group, 26 patients had subserosal invasion; 20 of these were reoperated and only 2 had a recurrence.
|Survival curves did not show differences.|
|World Journal of Surgery|
The team found that there were 6 patients with serosal infiltration in the laparoscopic group; 3 underwent reoperation.
There were 12 patients in the open group with serosal invasion; 6 were reoperated and 4 had a recurrence.
The team determined that overall survival curves did not show differences when patients were compared according to the type of procedure performed.
They also found, using analysis of patients according to the level of wall invasion, that there was no significant difference in survival.
Dr Xabier de Aretxabala and colleagues concluded, "Although multiple reports have shown a worse prognosis for patients with gallbladder cancer undergoing laparoscopic cholecystectomy, this study did not show a significant survival difference between the 2 methods".
"Although there is a higher but insignificant recurrence rate among the patients who underwent laparoscopic cholecystectomy, this is not translated into survival".