[Current surgical treatment for gallbladder cancer]

Area of Science:

• Surgical Oncology
• Gastrointestinal Oncology
• Hepatobiliary Surgery

Context:

• Gallbladder cancer (GBC) presents significant management challenges.
• Surgical resection is the primary curative treatment modality for GBC.
• Understanding hepatic spread mechanisms is crucial for optimizing surgical strategies.

Purpose:

• To review the role of aggressive surgical resection in managing gallbladder cancer.
• To discuss the modes of hepatic spread and their implications for surgical planning.
• To evaluate the indications and outcomes of extended hepatectomy and combined procedures for advanced GBC.

Summary:

• Aggressive surgical resection, including partial hepatectomy of the gallbladder bed, is essential for potentially curative outcomes in gallbladder cancer.
• Hepatic spread occurs mainly via direct liver invasion and lymphatic spread within portal tracts.
• Extended resections like combined hepatectomy and pancreaticoduodenectomy may benefit selected patients with locally advanced GBC, despite higher associated mortality.
• Management at high-volume centers and consideration of neoadjuvant/adjuvant chemotherapy are recommended for advanced disease.

Impact:

• This review highlights the importance of radical surgical approaches for improving survival in gallbladder cancer.
• It emphasizes the critical role of specialized centers and multidisciplinary management for complex cases.
• Optimized surgical strategies can improve the chances of cure and long-term survival for patients with gallbladder cancer.