Application of laparoscopic surgery in gallbladder carcinoma

Abstract

Gallbladder carcinoma (GC) is a rare type of cancer of the digestive system, with an incidence that varies by region. Surgery plays a primary role in the comprehensive treatment of GC and is the only known cure. Compared with traditional open surgery, laparoscopic surgery has the advantages of convenient operation and magnified field of view. Laparoscopic surgery has been successful in many fields, including gastrointestinal medicine and gynecology. The gallbladder was one of the first organs to be treated by laparoscopic surgery, and laparoscopic cholecystectomy has become the gold standard surgical treatment for benign gallbladder diseases. However, the safety and feasibility of laparoscopic surgery for patients with GC remain controversial. Over the past several decades, research has focused on laparoscopic surgery for GC. The disadvantages of laparoscopic surgery include a high incidence of gallbladder perforation, possible port site metastasis, and potential tumor seeding. The advantages of laparoscopic surgery include less intraoperative blood loss, shorter postoperative hospital stay, and fewer complications. Nevertheless, studies have provided contrasting conclusions over time. In general, recent research has tended to support laparoscopic surgery. However, the application of laparoscopic surgery in GC is still in the exploratory stage. Here, we provide an overview of previous studies, with the aim of introducing the application of laparoscopy in GC.

New trends in diagnosis and management of gallbladder carcinoma

“…According to applicable guidelines of the National Comprehensive Cancer Network, the European Society of Medical Oncology, the Japanese Society of Hepato-Biliary-Pancreatic Surgery, and the Chinese Surgical Society and Chinese Committee of Biliary Surgeons, open surgery is recommended as a rule and laparoscopic surgery only in selected cases and for research purposes[ 115 - 118 ]. This recommendation has been based on the fears and reservations regarding intraperitoneal cancer cell dissemination in cases of GB perforation and bile spillage, as well as the doubtful achievement of laparoscopic radicality and adequate lymphadenectomy mainly around the hepatoduodenal ligament and hepatic artery[ 39 , 86 , 119 - 121 ]. However, despite these uncertainties, by improving equipment and operative skills, advances in laparoscopic techniques[ 122 - 126 ] or even robotic management[ 38 , 127 ] can overcome the disadvantages and difficulties of laparoscopic procedures.…”