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Complete Laparoscopic Radical Resection of Perihilar Cholangiocarcinoma Type IIIb
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Selective laparoscopic approach in suspected gallbladder malignancy.

G Paul Wright1, Arida Siripong2, Michael D Winton3

  • 1Grand Rapids Medical Education Partners/Michigan State University General Surgery Residency Program, 1000 Monroe NW, Grand Rapids, MI 49503, USA; Michigan State University College of Human Medicine, Grand Rapids, MI, USA. paul.wright@grmep.com.

JSLS : Journal of the Society of Laparoendoscopic Surgeons
|January 9, 2014
PubMed
Summary
This summary is machine-generated.

Over half of patients with suspicious gallbladder findings had benign pathology. This suggests a laparoscopic approach may be suitable for selected patients with concerning gallbladder malignancy indicators.

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Area of Science:

  • Surgical Oncology
  • Gastroenterology
  • Diagnostic Imaging

Background:

  • Gallbladder malignancy presents diagnostic challenges.
  • Identifying factors for appropriate surgical approach is crucial.

Purpose of the Study:

  • Determine the incidence of confirmed gallbladder malignancy in patients with suspicious findings.
  • Identify predictors for selecting patients for an initial laparoscopic approach.

Main Methods:

  • Retrospective review of patients with concerning preoperative findings for gallbladder malignancy (2005-2011).
  • Data collected: demographics, imaging (CT, US, MRI), operative findings, pathology.
  • Patients categorized by preoperative findings: mass, wall thickening, or abnormal laparoscopy.

Main Results:

  • 29 of 4474 patients met inclusion criteria.
  • 48% of patients had pathology-confirmed gallbladder malignancy.
  • Patients without a discrete mass on imaging were more likely to have benign disease (P = .04).
  • 8 patients underwent initial laparoscopic approach with 3 conversions to open surgery.

Conclusions:

  • Over 50% of patients with suspicious preoperative findings had benign pathology.
  • An initial laparoscopic approach may be appropriate for carefully selected patients with suspicious gallbladder findings.