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Surgical Endoscopy

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05-10-2023 | Gallbladder Cancer | Original Article

Oncologic safety of robotic extended cholecystectomy for gallbladder cancer

Authors: Young Jae Cho, Won-Gun Yun, Hye-Sol Jung, Mirang Lee, Youngmin Han, Wooil Kwon, Jin-Young Jang

Published in: Surgical Endoscopy | Issue 12/2023

Abstract

Background

Although laparoscopic cholecystectomy is applicable for the treatment of early gallbladder cancer (GBC), minimally invasive surgery is not widely used for advanced GBC. This is because advanced GBCs necessitate complicated surgical techniques, including lymph node dissection and liver resection. Robotic extended cholecystectomy (REC) is thought to overcome the limitations of laparoscopic surgery, but oncological safety studies are lacking. Therefore, in this study, we aimed to evaluate the oncologic outcomes of REC compared with those of open extended cholecystectomy (OEC).

Methods

A total of 125 patients, who underwent extended cholecystectomy for GBC with tentative T2 or higher stage between 2018 and 2021, were included and stratified by surgical methods. To minimize the confounding factors, 1:1 propensity-score matching was performed between the patients who underwent REC and those who underwent OEC.

Results

Regarding short-term outcomes, the REC group showed significantly lower estimated blood loss (382.7 vs. 717.2 mL, P = 0.020) and shorter hospital stay (6.9 vs. 8.5 days, P = 0.042) than the OEC group. In addition, the REC group had significantly lower subjective pain scores than the OEC group from the day of surgery through the 5th postoperative day (P = 0.006). Regarding long-term outcomes, there were no significant differences in the 3-year [5-year] overall survival (OS) and disease-free survival (DFS) rates between the REC group [OS, 92.3% (92.3%); DFS, 84.6% (72.5%)] and the OEC group [OS, 96.8% (96.8%); DFS, 78.2% (78.2%)] (P = 0.807 for OS and 0.991 for DFS).

Conclusions

In this study, REC showed superior short-term outcomes to OEC and no difference in long-term survival outcomes. Additionally, REC was superior to OEC in terms of postoperative pain. Therefore, REC may be a feasible option with early recovery compared with OEC for patients with advanced GBC.

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Title: Oncologic safety of robotic extended cholecystectomy for gallbladder cancer
Authors: Young Jae Cho
Won-Gun Yun
Hye-Sol Jung
Mirang Lee
Youngmin Han
Wooil Kwon
Jin-Young Jang
Publication date: 05-10-2023
Publisher: Springer US
Keywords: Gallbladder Cancer
Gallbladder Cancer
Cholecystectomy
Liver Resection
Liver Resection
Minimally Invasive Surgery
Published in: Surgical Endoscopy / Issue 12/2023
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-023-10463-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Oncologic safety of robotic extended cholecystectomy for gallbladder cancer

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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