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Updated: Jun 3, 2026
Complete Laparoscopic Radical Resection of Perihilar Cholangiocarcinoma Type IIIb
Published on: January 17, 2025
Surgical resection for advanced gallbladder carcinoma. The Mount Sinai experience
Manousos M Konstadoulakis1, Sasan Roayaie, Ilias P Gomatos
1Recanati-Miller Transplantation Institute, Mount Sinai School of Medicine, New York, NY, USA. manousos.konstadoulakis@mountsinai.org
Background/Aims:
Advanced gallbladder cancer (GC) carries dismal prognosis, due to its extent at diagnosis and the low R0 resection performance rate.
Methodology:
Thirty-two GC patients referred to our Department with an intention to treat between 1993 and 2005. All patients had advanced T stage (> or = T3). Pathological findings, surgical procedures and survival data were analyzed.
Results:
Seventeen radical procedures (16 hepatectomies and 1 cholecystectomy with common bile duct resection), 4 palliative procedures (12.5%) and 11 surgical explorations (34.4%) were performed (53.1%, resectability rate). Hepatectomies were performed with 0% mortality, 11.8% morbidity and 94.1% resectability rate. The respective 1-, 3- and 5- year survival rates were 71.4%, 28.6% and 14.3%. Radical lymph node dissection (p = 0.03), absence of perineural tumor invasion (p = 0.03) and patients' age <70 years (p < 0.01) were non-independently associated with favorable prognosis in the hepatectomy-treated group of GC patients.
Conclusions:
GC patients with stage > or = IIA should be treated with hepatectomy combined with radical lymphadenectomy in order to achieve better staging and disease control. Incorporating the caudate lobe, more than 4 liver segments, or part of the extrahepatic biliary tree in the resection specimen in selected patients, might help eliminate perineural metastatic spread and achieve improved overall survival.
