Current Role of Minimally Invasive Radical Cholecystectomy for Gallbladder Cancer

Background. For Tis and T1a gallbladder cancer (GbC), laparoscopic cholecystectomy can provide similar survival outcomes compared to open cholecystectomy. However, for patients affected by resectable T1b or more advanced GbC, open approach radical cholecystectomy (RC), consisting in gallbladder live...

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Bibliographic Details
Published in:Gastroenterology research and practice 2016-01, Vol.2016 (2016), p.1-8
Main Authors: Rosso, Edoardo, Aroldi, Francesca, Bertocchi, Paola, Ramera, Marco, Guerini, Francesca, Manzoni, Alberto, Zimmitti, Giuseppe, Zaniboni, Alberto
Format: Article
Language:English
Subjects:
Analysis
Bile
Care and treatment
Cholecystectomy
Gallbladder
Gallbladder cancer
Hypotheses
Laparoscopy
Lymphatic system
Review
Studies
Surgery
Treatment outcome
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Summary:Background. For Tis and T1a gallbladder cancer (GbC), laparoscopic cholecystectomy can provide similar survival outcomes compared to open cholecystectomy. However, for patients affected by resectable T1b or more advanced GbC, open approach radical cholecystectomy (RC), consisting in gallbladder liver bed resection or segment 4b-5 bisegmentectomy, with locoregional lymphadenectomy, is considered the gold standard while minimally invasive RC (MiRC) is skeptically considered. Aim. To analyze current literature on perioperative and oncologic outcomes of MiRC for patients affected by GbC. Methods. A Medline review of published articles until June 2016 concerning MiRC for GbC was performed. Results. Data relevant for this review were presented in 13 articles, including 152 patients undergoing an attempt of MiRC for GbC. No randomized clinical trial was found. The approach was laparoscopic in 147 patients and robotic in five. Conversion was required in 15 (10%) patients. Postoperative complications rate was 10% with no mortality. Long-term survival outcomes were reported by 11 studies, two of them showing similar oncologic results when comparing MiRC with matched open RC. Conclusions. Although randomized clinical trials are still lacking and only descriptive studies reporting on limited number of patients are available, current literature seems suggesting that when performed at highly specialized centers, MiRC for GbC is safe and feasible and has oncologic outcomes comparable to open RC.
ISSN:1687-6121
1687-630X
DOI:10.1155/2016/7684915