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Laparoscopic approach to suspected T1 and T2 gallbladder carcinoma
Yusuke Ome1, Kazuki Hashida1, Mitsuru Yokota1
1Yusuke Ome, Kazuki Hashida, Mitsuru Yokota, Yoshio Nagahisa, Michio Okabe, Kazuyuki Kawamoto, Department of Surgery, Kurashiki Central Hospital, Kurashiki, Okayama 710-8602, Japan.
Aim:
To evaluate a laparoscopic approach to gallbladder lesions including polyps, wall-thickening lesions, and suspected T1 and T2 gallbladder cancer (GBC).
Methods:
We performed 50 cases of laparoscopic whole-layer cholecystectomy (LCWL) and 13 cases of laparoscopic gallbladder bed resection (LCGB) for those gallbladder lesions from April 2010 to November 2016. We analyzed the short-term and long-term results of our laparoscopic approach.
Results:
The median operation time was 108 min for LCWL and 211 min for LCGB. The median blood loss was minimal for LCWL and 28 ml for LCGB. No severe morbidity occurred in either procedure. Nine patients who underwent LCWL and 7 who underwent LCGB were postoperatively diagnosed with GBC. One of these patients had undergone LCGB for pathologically diagnosed T2 GBC after LCWL. All of the final surgical margins were negative. Three of these 15 patients underwent additional open surgery. The mean follow-up period was 26 mo, and only one patient developed recurrence.
Conclusion:
LCWL and LCGB are safe and useful procedures that allow complete resection of highly suspected or early-stage cancer and achieve good short-term and long-term results.
