Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on sleep in brain health

LIVE: Thursday 2nd May 2024, 18:00-19:30 (CEST)

Quality sleep is essential for health. But what happens to our brains when sleep patterns are disturbed? Join our experts to explore the interplay between sleep disruption and neurological diseases, and the questions that you need to be asking your patients to help you prevent the harmful effects of sleep deprivation.
ADVANCED SEARCH
Log in
Top
Surgical Endoscopy
Published in: Surgical Endoscopy 7/2020

01-07-2020 | Gallbladder Cancer

Laparoscopy versus laparotomy approach of a radical resection for gallbladder cancer: a retrospective comparative study

Authors: Changwei Dou, Yuhua Zhang, Jie Liu, Fangqiang Wei, Hongwu Chu, Junjun Han, Qifeng Yao, Jianyi Ding, Chengwu Zhang

Published in: Surgical Endoscopy | Issue 7/2020

Login to get access

Abstract

Background

Laparoscopic approach for gallbladder cancer (GBC) has long been contraindicated, but few recent studies have demonstrated the oncologic outcomes of this treatment. The purpose of this study was to compare the perioperative outcomes and long-term survival for laparoscopic surgery versus traditional open surgery of GBC.

Method

Between January 2014 and December 2018, 63 GBC patients who received radical resection were enrolled in this study, with 32 patients in laparoscopic group and 31 cases in laparotomy group. Perioperative data and postoperative survival were retrospectively evaluated.

Results

Laparoscopic approach was associated with less intraoperative bleeding (267.20 ± 47.07 vs. 502.60 ± 69.70, P = 0.007), fewer postoperative days of oral diet recovery (2.34 ± 0.31 vs. 3.32 ± 0.35, P = 0.041), and hospital stay (11.03 ± 0.99 vs. 14.35 ± 1.11, P = 0.028). There were no significant differences between two groups regarding other perioperative outcomes. Patients in laparoscopic group showed better 1-year overall survival than those in laparotomy group (72.91% vs. 47.82%, P = 0.086). Subgroup analysis for GBC patients in T3 stages revealed that laparoscopic approach was associated with less intraoperative bleeding (268.00 ± 57.19 vs. 541.50 ± 101.30, P = 0.009), fewer postoperative days of hospital stay (9.87 ± 1.10 vs. 14.90 ± 1.53, P = 0.017), and improved 1-year overall survival (P = 0.023). Subgroup analysis for GBCs in TNM III and TNM IV stages showed comparable intraoperative parameters and postoperative survival between two groups.

Conclusion

Laparoscopic surgery for GBCs may offer the comparable perioperative outcomes as conventional laparotomy procedure, and tend to be associated with less intraoperative bleeding, faster oral diet recovery, shorter hospital stay, and improved 1-year overall survival.
Literature
1.
2.
Dixon E, Vollmer CM Jr, Sahajpal A, Cattral M, Grant D, Doig C, Hemming A, Taylor B, Langer B, Greig P, Gallinger S (2005) An aggressive surgical approach leads to improved survival in patients with gallbladder cancer: a 12-year study at a North American Center. Ann Surg 241:385–394CrossRef
3.
Kim YW, Yoon HM, Yun YH, Nam BH, Eom BW, Baik YH, Lee SE, Lee Y, Kim YA, Park JY, Ryu KW (2013) Long-term outcomes of laparoscopy-assisted distal gastrectomy for early gastric cancer: result of a randomized controlled trial (COACT 0301). Surg Endosc 27:4267–4276CrossRef
4.
Lacy AM, Garcia-Valdecasas JC, Delgado S, Castells A, Taura P, Pique JM, Visa J (2002) Laparoscopy-assisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: a randomised trial. Lancet 359:2224–2229CrossRef
5.
Kaneko H, Takagi S, Otsuka Y, Tsuchiya M, Tamura A, Katagiri T, Maeda T, Shiba T (2005) Laparoscopic liver resection of hepatocellular carcinoma. Am J Surg 189:190–194CrossRef
6.
Reddy YP, Sheridan WG (2000) Port-site metastasis following laparoscopic cholecystectomy: a review of the literature and a case report. Eur J Surg Oncol 26:95–98CrossRef
7.
Berger-Richardson D, Chesney TR, Englesakis M, Govindarajan A, Cleary SP, Swallow CJ (2017) Trends in port-site metastasis after laparoscopic resection of incidental gallbladder cancer: a systematic review. Surgery 161:618–627CrossRef
8.
Cho JY, Han HS, Yoon YS, Ahn KS, Kim YH, Lee KH (2010) Laparoscopic approach for suspected early-stage gallbladder carcinoma. Arch Surg 145:128–133CrossRef
9.
Agarwal AK, Javed A, Kalayarasan R, Sakhuja P (2015) Minimally invasive versus the conventional open surgical approach of a radical cholecystectomy for gallbladder cancer: a retrospective comparative study. HPB 17:536–541CrossRef
10.
Itano O, Oshima G, Minagawa T, Shinoda M, Kitago M, Abe Y, Hibi T, Yagi H, Ikoma N, Aiko S, Kawaida M, Masugi Y, Kameyama K, Sakamoto M, Kitagawa Y (2015) Novel strategy for laparoscopic treatment of pT2 gallbladder carcinoma. Surg Endosc 29:3600–3607CrossRef
11.
Shirobe T, Maruyama S (2015) Laparoscopic radical cholecystectomy with lymph node dissection for gallbladder carcinoma. Surg Endosc 29:2244–2250CrossRef
12.
Palanisamy S, Patel N, Sabnis S, Palanisamy N, Vijay A, Palanivelu P, Parthasarthi R, Chinnusamy P (2016) Laparoscopic radical cholecystectomy for suspected early gall bladder carcinoma: thinking beyond convention. Surg Endosc 30:2442–2448CrossRef
13.
Yoon YS, Han HS, Cho JY, Choi Y, Lee W, Jang JY, Choi H (2015) Is laparoscopy contraindicated for gallbladder cancer? A 10-year prospective cohort study. J Am Coll Surg 221:847–853CrossRef
14.
Edge SB, Compton CC (2010) The American Joint Committee on Cancer: the 7th edition of the AJCC cancer staging manual and the future of TNM. Ann Surg Oncol 17(6):1471–1474CrossRef
15.
Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205–213CrossRef
16.
Koch M, Garden OJ, Padbury R, Rahbari NN, Adam R, Capussotti L, Fan ST, Yokoyama Y, Crawford M, Makuuchi M, Christophi C, Banting S, Brooke-Smith M, Usatoff V, Nagino M, Maddern G, Hugh TJ, Vauthey JN, Greig P, Rees M, Nimura Y, Figueras J, DeMatteo RP, Buchler MW, Weitz J (2011) Bile leakage after hepatobiliary and pancreatic surgery: a definition and grading of severity by the International Study Group of Liver Surgery. Surgery 149:680–688CrossRef
17.
Birnbaum DJ, Vigano L, Russolillo N, Langella S, Ferrero A, Capussotti L (2015) Lymph node metastases in patients undergoing surgery for a gallbladder cancer. Extension of the lymph node dissection and prognostic value of the lymph node ratio. Ann Surg Oncol 22:811–818CrossRef
18.
Liu GJ, Li XH, Chen YX, Sun HD, Zhao GM, Hu SY (2013) Radical lymph node dissection and assessment: impact on gallbladder cancer prognosis. World J Gastroenterol 19:5150–5158CrossRef
19.
Ong CT, Leung K, Nussbaum DP, Sun Z, Gloor B, Blazer DG 3rd, Worni M (2018) Open versus laparoscopic portal lymphadenectomy in gallbladder cancer: is there a difference in lymph node yield? HPB 20:505–513CrossRef
20.
Evrard S, Falkenrodt A, Park A, Tassetti V, Mutter D, Marescaux J (1997) Influence of CO2 pneumoperitoneum on systemic and peritoneal cell-mediated immunity. World J Surg 21:353–356CrossRef
21.
Nguyen KT, Gamblin TC, Geller DA (2009) World review of laparoscopic liver resection-2,804 patients. Ann Surg 250:831–841CrossRef
22.
D’Angelica M, Dalal KM, DeMatteo RP, Fong Y, Blumgart LH, Jarnagin WR (2009) Analysis of the extent of resection for adenocarcinoma of the gallbladder. Ann Surg Oncol 16:806–816CrossRef
23.
Goetze TO, Paolucci V (2010) Adequate extent in radical re-resection of incidental gallbladder carcinoma: analysis of the German Registry. Surg Endosc 24:2156–2164CrossRef
24.
Horiguchi A, Miyakawa S, Ishihara S, Miyazaki M, Ohtsuka M, Shimizu H, Sano K, Miura F, Ohta T, Kayahara M, Nagino M, Igami T, Hirano S, Yamaue H, Tani M, Yamamoto M, Ota T, Shimada M, Morine Y, Kinoshita H, Yasunaga M, Takada T (2013) Gallbladder bed resection or hepatectomy of segments 4a and 5 for pT2 gallbladder carcinoma: analysis of Japanese registration cases by the study group for biliary surgery of the Japanese Society of Hepato-Biliary-Pancreatic Surgery. J Hepatobiliary Pancreat Sci 20:518–524CrossRef
Metadata
Title
Laparoscopy versus laparotomy approach of a radical resection for gallbladder cancer: a retrospective comparative study
Authors
Changwei Dou
Yuhua Zhang
Jie Liu
Fangqiang Wei
Hongwu Chu
Junjun Han
Qifeng Yao
Jianyi Ding
Chengwu Zhang
Publication date
01-07-2020
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 7/2020
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-019-07075-4

Other articles of this Issue 7/2020

Surgical Endoscopy 7/2020 Go to the issue

2019 SAGES Oral

The impact of nausea on post-operative outcomes in bariatric surgery patients

OriginalPaper

Surgeon-delivered laparoscopic transversus abdominis plane blocks are non-inferior to anesthesia-delivered ultrasound-guided transversus abdominis plane blocks: a blinded, randomized non-inferiority trial

OriginalPaper

Laparoscopic resection with complete mesocolic excision for splenic flexure cancer: long-term follow-up data from a multicenter retrospective study

OriginalPaper

Laparoscopic partial nephrectomy without clamping the renal pedicle

OriginalPaper

Effect of peroral endoscopic myotomy in geriatric patients: a propensity score matching study

2019 SAGES Oral

Third-time (“redo–redo”) anti-reflux surgery: patient-reported outcomes after a thoracoabdominal approach