Retrospective Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Apr 14, 2017; 23(14): 2556-2565
Published online Apr 14, 2017. doi: 10.3748/wjg.v23.i14.2556
Laparoscopic approach to suspected T1 and T2 gallbladder carcinoma
Yusuke Ome, Kazuki Hashida, Mitsuru Yokota, Yoshio Nagahisa, Michio Okabe, Kazuyuki Kawamoto
Yusuke Ome, Kazuki Hashida, Mitsuru Yokota, Yoshio Nagahisa, Michio Okabe, Kazuyuki Kawamoto, Department of Surgery, Kurashiki Central Hospital, Kurashiki, Okayama 710-8602, Japan
Author contributions: Ome Y designed the study, gathered the clinical data, and wrote the manuscript; all authors decided on courses of treatment and performed the operations; Ome Y, Hashida K, Yokota M and Nagahisa Y analyzed the data; all authors helped with drafts, reviewed the manuscript, and approved it.
Institutional review board statement: This retrospective study was reviewed and approved by the Institution Review Board of Kurashiki Central Hospital.
Informed consent statement: Patients were not required to give informed consent to this study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: None of the authors have conflicts of interest to declare.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Yusuke Ome, MD, Assistant Director, Department of Surgery, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama 710-8602, Japan. yo14408@kchnet.or.jp
Telephone: +81-86-4220210 Fax: +81-86-4213424
Received: February 6, 2017
Peer-review started: February 8, 2017
First decision: March 3, 2017
Revised: March 13, 2017
Accepted: March 20, 2017
Article in press: March 20, 2017
Published online: April 14, 2017
Processing time: 67 Days and 13.9 Hours
Abstract
AIM

To evaluate a laparoscopic approach to gallbladder lesions including polyps, wall-thickening lesions, and suspected T1 and T2 gallbladder cancer (GBC).

METHODS

We performed 50 cases of laparoscopic whole-layer cholecystectomy (LCWL) and 13 cases of laparoscopic gallbladder bed resection (LCGB) for those gallbladder lesions from April 2010 to November 2016. We analyzed the short-term and long-term results of our laparoscopic approach.

RESULTS

The median operation time was 108 min for LCWL and 211 min for LCGB. The median blood loss was minimal for LCWL and 28 ml for LCGB. No severe morbidity occurred in either procedure. Nine patients who underwent LCWL and 7 who underwent LCGB were postoperatively diagnosed with GBC. One of these patients had undergone LCGB for pathologically diagnosed T2 GBC after LCWL. All of the final surgical margins were negative. Three of these 15 patients underwent additional open surgery. The mean follow-up period was 26 mo, and only one patient developed recurrence.

CONCLUSION

LCWL and LCGB are safe and useful procedures that allow complete resection of highly suspected or early-stage cancer and achieve good short-term and long-term results.

Keywords: Laparoscopic cholecystectomy; Whole-layer cholecystectomy; Gallbladder bed resection; Radical cholecystectomy; Gallbladder carcinoma

Core tip: Laparoscopic cholecystectomy is commonly performed for the treatment of benign diseases. Gallbladder carcinoma (GBC) is typically managed by open surgery because of various concerns associated with potential dissemination, recurrence, and technical difficulties. However, many benign lesions are difficult to differentiate from GBC, including polyps and lesions that cause wall thickening. We use a laparoscopic approach for many types of gallbladder lesions including gallbladder carcinoma. This study demonstrated that our laparoscopic approach is safe, useful, and allows for the complete resection of highly suspected or early-stage gallbladder cancer.