Survey Results of the Expert Meeting on Laparoscopic Surgery for Gallbladder Cancer and a Review of Relevant Literature

Abstract

Background: Favorable outcomes of laparoscopic surgery for gallbladder cancer (GBC) have been reported; yet consensus on the indications and surgical techniques for laparoscopic surgery for GBC is lacking. Objective: To evaluate the current status of laparoscopic surgery for GBC by analyzing the results of a survey of experts and by reviewing the relevant published literature. Methods: Before an expert meeting was held on September 10, 2016 in Seoul, Korea, an international survey was undertaken of expert surgeons in the field of GBC surgery. Results: The majority of surgeons who responded agreed that laparoscopic surgery has an acceptable role for suspicious or early GBC, and that laparoscopic extended cholecystectomy has a value comparable to that of open surgery in selected patients with GBC. However, the selection criteria for laparoscopic surgery for overt GBC and the details of the surgical techniques varied among surgeons. Conclusions: This survey and literature review revealed that laparoscopic surgery for GBC is performed in highly selected cases. However, the favorable outcomes in the published reports and the positive view of experienced surgeons for this operative procedure suggest a high likelihood that laparoscopic surgery will be more frequently performed for GBC in the future.

Systematic review of management of incidental gallbladder cancer after cholecystectomy

“…Increasingly, studies are reporting on the outcome of laparoscopic resections in gallbladder cancers as well as in redo surgery for incidental gallbladder cancers. In general, there are no clear adverse outcomes from laparoscopic resections compared with open operations, and the laparoscopic access route is increasingly entertained and promoted by specialists. One concern is that laparoscopic access has been associated with a reduced lymph node yield.…”

Laparoscopic radical cholecystectomy with common bile duct resection for T2 gallbladder cancer

“…The current recommended surgical approach for preoperative suspected T2 gallbladder cancer is open radical cholecystectomy, which includes en bloc liver resection (wedge resection or segment 4b/5 resection) and regional lymphadenectomy. Yet, until recently, there is still no consensus as to whether an open approach is superior to laparoscopic surgery 5. However, in high volume centers with more experience in minimally invasive surgery, laparoscopic radical cholecystectomy is currently being employed with an oncologic safety and long-term outcome comparable to open approach 678…”

Prognostic factors and patterns of loco-regional failure in patients with R0 resected gallbladder cancer

“…Surgical standardization in GB cancer is a difficult issue, which has led to establish several consensuses guidelines. [13][14][15] Based on these guidelines, a surgical principle has been shared and kept in our institute involving no gallbladder perforation, R0 resection (including bile duct resection, liver resection if necessary), and adequate regional lymph node dissection. Simple cholecystectomy was defined as cholecystectomy without hepatic resection or lymph node dissection.…”