Minimally invasive radical surgery for gallbladder cancer: a single-unit experience of over 200 patients

Most published studies on minimally invasive radical cholecystectomy (MIRC) for gallbladder cancer (GBC) are limited by a small sample size, disproportionately high incidental GBC patients, and a lack of long-term outcomes. The present study aims to report the long-term oncological outcomes of MIRC in a large series of primary and locally advanced GBC patients.

A retrospective analysis was conducted using prospectively collected data from primary and incidental GBC patients who underwent MIRC between March 2011 and June 2023. Patients who underwent MIRC and had benign pathology on final histopathological examination were excluded from the analysis. Perioperative short- and long-term oncological outcomes were analyzed.

During the study period, 222 patients with suspected GBC underwent MIRC. The mean age was 49.5 ± 12.5 years with a female-to-male ratio of 4.2:1. The mean operative time and blood loss were 232 ± 55.3 min and 153.8 ± 68.4 mL, respectively. 205 patients with malignancy on final histopathology were included in the analysis of oncological outcomes. The overall median (95% CI) survival, 3-year and 5-year survival rates were 60 (41-62) months, 62.3% and 42.9%, respectively. The median survival was significantly higher in early-stage (T1/T2) GBC compared to locally advanced (T3/T4) tumors (66 vs. 36 months, P < 0.0001). Also, node-negative GBC patients had better overall survival than node-positive tumors (68 vs. 34 months, P < 0.0001). None of the patients had port-site recurrence.

The largest single-unit series published to date documents the oncological efficacy of MIRC for GBC.