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01-12-2015

Novel strategy for laparoscopic treatment of pT2 gallbladder carcinoma

Authors: Osamu Itano, Go Oshima, Takuya Minagawa, Masahiro Shinoda, Minoru Kitago, Yuta Abe, Taizo Hibi, Hiroshi Yagi, Naruhiko Ikoma, Satoshi Aiko, Miho Kawaida, Yohei Masugi, Kaori Kameyama, Michiie Sakamoto, Yuko Kitagawa

Published in: Surgical Endoscopy | Issue 12/2015

Abstract

Background

This study evaluated our new strategy for treating suspected T2 gallbladder carcinoma (GBC) using a laparoscopic approach.

Methods

We examined 19 patients with suspected T2 GBC who were treated laparoscopically (LS group) between December 2007 and December 2013; these patients were compared with 14 patients who underwent open surgery (OS group). Laparoscopic staging was initially performed to exclude factors making the patients ineligible for curative resection. Intraoperative pathological examination of the surgical margin of the cystic duct was performed prior to laparoscopic gallbladder bed resection, and pathological examination was again performed to confirm the presence of carcinoma and the depth of tumor invasion. Surgery was completed when the pathological findings indicated that the patient was cancer free. Lymph node dissection was performed according to the depth of tumor invasion.

Results

None of the patients required conversion to laparotomy. For three patients with benign lesions, only gallbladder bed resection was required. Additional regional lymph node dissection was performed in 16 patients in the LS group. The mean operative time (309 vs. 324 min, p = 0.755) and mean number of dissected lymph nodes (12.6 vs. 10.2, p = 0.361) were not significantly different between the LS and OS groups. The intraoperative blood loss was significantly lower (104 vs. 584 mL, p = 0.002) and the postoperative hospital stay was significantly shorter (9.1 vs. 21.6 days, p = 0.002) for LS patients than for those in the OS group. In the LS group, one patient developed postoperative pneumonia, but all patients survived without recurrence after a mean follow-up of 37 months.

Conclusion

Our strategy for suspected T2 gallbladder GBC is safe and useful, avoids unnecessary procedures, and is associated with similar oncologic outcomes as the open method.

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Title: Novel strategy for laparoscopic treatment of pT2 gallbladder carcinoma
Authors: Osamu Itano
Go Oshima
Takuya Minagawa
Masahiro Shinoda
Minoru Kitago
Yuta Abe
Taizo Hibi
Hiroshi Yagi
Naruhiko Ikoma
Satoshi Aiko
Miho Kawaida
Yohei Masugi
Kaori Kameyama
Michiie Sakamoto
Yuko Kitagawa
Publication date: 01-12-2015
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 12/2015
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-015-4116-y

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Novel strategy for laparoscopic treatment of pT2 gallbladder carcinoma

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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