Laparoscopic surgery for oncologic extended resection of T1b and T2 incidental gallbladder carcinoma at a high-volume center: a single-center experience in China

Background Surgical treatment is still the most effective treatment for gallbladder cancer. For the patients with stage T1b and above, the current guidelines recommend the extended radical operation, and oncologic extended resection can benefit the survival of the patients. The laparoscopic approach is still in the early phase, and its safety and oncological outcomes are not well known. Objective To evaluate the technical feasibility and oncological outcomes of laparoscopic surgery for oncologic extended resection of early-stage incidental gallbladder carcinoma. Results This study included 18 male and 32 female patients. Twenty patients underwent laparoscopic oncologic extended resection and 30 patients underwent open oncologic extended resection. All of the patients had R0 resection. A laparoscopic approach was associated with less intraoperative blood loss (242 +/- 108.5 vs 401 +/- 130.3; p < 0.01) and shorter duration of postoperative hospital stay (6.2 +/- 2.4 vs 8.6 +/- 2.3; p < 0.01). There was no statistically significant difference between two groups for lymph nodes yield (5.4 +/- 3.5 vs 5.8 +/- 2.1; p > 0.05), incidence of lymphatic metastasis (15% vs 16.67%; p > 0.05), residual disease (20% vs 23.3%; p > 0.05), and postoperative morbidity (15% vs 20%; p > 0.05). During follow-up time of median 20.95 (12-29.5) months, no significant difference was found between the two groups for early tumor recurrence (10% vs 13.33%; p > 0.05) and disease-free survival (p > 0.05). Conclusion Laparoscopic surgery may offer similar intraoperative, perioperative, and short-term oncological outcomes as an open oncologic extended resection for incidental gallbladder carcinoma.

Automated summary

In this study, laparoscopic surgery for oncologic extended resection of early-stage incidental gallbladder carcinoma showed similar intraoperative, perioperative, and short-term oncological outcomes as open oncologic extended resection. The laparoscopic approach was associated with less intraoperative blood loss and shorter postoperative hospital stay. No significant differences were found in lymph nodes yield, lymphatic metastasis, residual disease, postoperative morbidity, early tumor recurrence, and disease-free survival between the two groups during follow-up.