Radical cholecystectomy without liver resection for peritoneal side early incidental gallbladder cancer

Abstract

Gallbladder cancer (GBC) is a rare disease with a poor prognosis. Simple cholecystectomy may be an adequate treatment only for very early disease (Tis, T1a), whereas reoperation is recommended for more advanced disease (T1b and T2). Radical cholecystectomy should have two fundamental objectives: To radically resect the liver parenchyma and to achieve adequate clearance of the lymph nodes. However, recent studies have shown that compared with lymph node dissection alone, liver resection does not improve survival outcomes. The oncological roles of lymphadenectomy and liver resection is distinct. Therefore, for patients with incidental GBC without liver invasion, hepatic resection is not always mandatory.

Keywords: Incidental gallbladder cancer; Reoperation; Radical cholecystectomy; Early stage; Liver resection

Core Tip: Hepatic resection for incidental gallbladder cancer (IGC) should aim to: Remove the tumor that has directly invaded the liver through the gallbladder bed and prevent micrometastases that may recur around the gallbladder bed. No consensus is available regarding the extension of liver resection according to its tumor location (hepatic or peritoneal side) and whether hepatic resection can prevent liver recurrence. According to the recent studies, radical cholecystectomy without liver resection may be an adequate treatment for patients with peritoneal side T2 IGC.