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Published on: March 10, 2023
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Standardized lymph node dissection for gallbladder cancer under laparoscopy: en-bloc resection technique.
Jian Cheng1, Jie Liu1, Chang-Wei Dou1
1General Surgery, Cancer Center, Department of Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, 310014, Zhejiang, China.
Langenbeck'S Archives of Surgery
|May 8, 2023
Summary
A new standardized laparoscopic lymph node dissection (LND) for gallbladder cancer (GBCA) ensures complete lymph node removal. This safe and effective technique shows promising survival rates and low complication rates for GBCA patients.
Area of Science:
- Surgical Oncology
- Gastrointestinal Surgery
- Gallbladder Cancer Research
Background:
- Positive lymph nodes (LN) are critical prognostic indicators in resected gallbladder cancer (GBCA).
- Current lymph node dissection (LND) methods for GBCA lack standardization in number and extent.
- Adequate lymphadenectomy is infrequently performed, impacting patient outcomes.
Purpose of the Study:
- To develop a standardized, en bloc laparoscopic lymph node dissection (LND) procedure for gallbladder cancer (GBCA).
- To establish a consistent surgical approach for radical LND in GBCA patients.
Main Methods:
- Retrospective analysis of perioperative and long-term outcomes.
- Data collected from patients undergoing laparoscopic radical resection with a standardized, en bloc LND technique.
- Evaluation of 39 GBCA patients, with one open conversion (2.6%).
Main Results:
- The standardized en bloc LND achieved a high rate of lymphadenectomy (≥6 LNs) across stages (81.3%-93.3%).
- Stage T1b patients showed significantly lower LN involvement rates and better survival compared to T3.
- Promising survival rates observed: 80% 2-year RFS for T2, 73.3% 3-year OS for T2; 25% 2-year RFS for T3, 37.5% 3-year OS for T3.
Conclusions:
- Standardized en bloc LND is a safe, feasible, and effective technique for radical lymph node removal in GBCA.
- The procedure is associated with low complication rates and favorable short-term prognosis.
- Further research is needed to compare long-term outcomes with conventional LND approaches.
