Benchmarks and Geographic Differences in Gallbladder Cancer Surgery: An International Multicenter Study

Area of Science:

• Oncology
• Surgical Oncology
• Gastrointestinal Surgery

Background:

• High-quality surgery is essential for optimal oncologic care.
• Establishing benchmark values allows for the assessment of achievable surgical results.
• Gallbladder cancer (GBC) surgery requires defined quality standards.

Purpose of the Study:

• To define international benchmark values for gallbladder cancer (GBC) surgery.
• To establish standards for assessing GBC surgical quality and outcomes.

Main Methods:

• Retrospective analysis of 906 patients undergoing curative-intent GBC surgery (2000-2021) at 13 international centers.
• Benchmark group comprised patients from high-volume centers without vascular/bile duct reconstruction or significant comorbidities.
• Data collected on patient demographics, operative details, and postoperative outcomes.

Main Results:

• 245 patients (27%) formed the benchmark group, predominantly women (71%), median age 64.
• Benchmark complication rates: ≤22% overall, ≤11% for major (Clavien-Dindo grade ≥ IIIa) complications.
• Key benchmarks established: ≥4 lymph nodes retrieved, blood loss ≤350 mL, hospital stay ≤8 days, R1 margin ≤7%.

Conclusions:

• Gallbladder cancer surgery is associated with considerable morbidity.
• Defined benchmark values provide a framework for comparing GBC surgical approaches and centers.
• These benchmarks can guide quality improvement initiatives in GBC surgical care.