Application of laparoscopic surgery in gallbladder carcinoma

Table 1 Definition of T-stage for gallbladder carcinoma

T category	T criteria
Tx	Primary tumor cannot be assessed
T0	No evidence of primary tumor
Tis	Carcinoma in situ
T1	Tumor invades the lamina propria or muscular layer
T1a	Tumor invades the lamina propria
T1b	Tumor invades the muscular layer
T2	Tumor invades the perimuscular connective tissue on the peritoneal side, without involvement of the serosa (visceral peritoneum) or tumor invades the perimuscular connective tissue on the hepatic side, with no extension into the liver
T2a	Tumor invades the perimuscular connective tissue on the peritoneal side, without involvement of the serosa (visceral peritoneum)
T2b	Tumor invades the perimuscular connective tissue on the hepatic side, with no extension into the liver
T3	Tumor perforates the serosa (visceral peritoneum) and/or directly invades the liver and/or one other adjacent organ or structure, such as the stomach, duodenum, colon, pancreas, omentum, or extrahepatic bile ducts
T4	Tumor invades the main portal vein or hepatic artery or invades two or more extrahepatic organs or structures

According to the AJCC 2018 TNM classification, 8^th edition.

Table 2 Definition of N-stage for gallbladder carcinoma

N category	N criteria
Nx	Regional lymph nodes cannot be assessed
N0	No regional lymph node metastasis
N1	Metastases to one to three regional lymph nodes
N2	Metastases to four or more regional lymph nodes

According to the AJCC 2018 TNM classification, 8^th edition.

Table 3 Data of several existing studies in recent years

No.	1	2	3	4	5
Year	2019	2021	2020	2021	2022
Ref.	Feng et al[59]	Regmi et al[70]	Navarro et al[69]	Kim et al[68]	Cho et al[72]
Country	China	China	Korea	Korea	Korea
Number of patients (n)
Laparoscopy	41	20	43	17	19
Laparotomy	61	30	43	17	19
Operation time (min)
Laparoscopy	137 ± 92	258.3 ± 72.5	139.1 ± 97.1	175 (160-180)	218.9 ± 145.0
Laparotomy	168 ± 51	227.0 ± 59.8	211.2 ± 91.4	156 (120-191)	316.8 ± 80.3
P value	0.058	0.101	0.001	0.370	0.016
Blood loss (mL)
Laparoscopy	358 ± 390	242 ± 108.5	71.6 ± 178.8	300 (300-500)	-
Laparotomy	386 ± 391	401 ± 130.3	208.1 ± 242.2	300 (200-900)	-
P value	0.732	< 0.01	0.004	0.846	-
Postoperative hospital stays (d)
Laparoscopy	5 ± 3	6.2 ± 2.4	6.1 ± 9.8	7.0 (7.0-9.0)	8.4 ± 5.91
Laparotomy	11 ± 5	8.6 ± 2.3	12.6 ± 5.5	12.0 (10.0-14.0)	14.4 ± 6.01
P value	< 0.001	< 0.01	0.0001	0.009	0.004
Perforation (n)
Laparoscopy	8	-	-	-	0
Laparotomy	3	-	-	-	0
P value	0.069	-	-	-	-
Recurrence and metastasis (n)
Laparoscopy	12	2	-	3	-
Laparotomy	10	4	-	2	-
P value	0.121	0.722	-	0.446	-
3-yr survival rates
Laparoscopy	-	-	-	71.5%2	88.9%
Laparotomy	-	-	-	82.4%2	86.3%
P value	-	-	-	0.94	0.660
5-yr survival rates
Laparoscopy	51.9%	-	64.0%	-	-
Laparotomy	55.7%	-	80.4%	-	-
P value	0.453	-	0.214	-	-

¹Hospital stays.

²Disease-free survival.