Does laparoscopy worsen the prognosis for incidental gallbladder cancer?

Background: More than 75% of cholecystectomies are done laparoscopically and less than one-third of gallbladder carcinomas are known presurgically. It is supposed that the laparoscopic technique could adversely affect the prognosis of gallbladder cancer. Methods: The C-A-E has started a register of all cases of cholecystectomy with a postoperative incidental finding of gallbladder carcinoma. The aim is to compare the prospectively collected follow-up data on the outcome of these patients and to answer the question of whether laparoscopic cholecystectomy affects the prognosis of incidental gallbladder cancer. Results: A total of 377 cases have been recorded so far. These include 201 patients treated by the laparoscopic procedure, 119 by an open procedure, and 57 by an intraoperative conversion. The survival shows a significantly better life expectancy for the patients treated laparoscopically. Conclusion: The life expectancy is higher for the laparoscopically treated patients and this cannot be explained by the fact that the laparoscopic technique is used to treat the earlier stages of cancer. The access technique does not seem to influence the prognosis for gallbladder carcinomas.