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Port Site Excision During Completion Extended Cholecystectomy for Incidental Gallbladder Cancer - A Scoping Review
Vaibhav Kumar Varshney1, Sanjamjot Singh1, Sameer Pandya2
1Department of Surgical Gastroenterology, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan, India.
Background:
Completion extended cholecystectomy (CEC) is the standard treatment for incidental gallbladder cancer (iGBC) to reduce early recurrence and improve survival. However, the necessity of laparoscopic port site excision (PSE) during CEC remains controversial. This scoping review evaluates whether routine PSE is warranted in the management of iGBC.
Methods:
A systematic search was conducted across PubMed, Google Scholar, Scopus, and the Cochrane Library using keywords such as "incidental gallbladder carcinoma," "radical cholecystectomy," "extended cholecystectomy," "port site excision," "port site recurrence," and "port site metastasis."
Results:
Three original studies involving 503 iGBC patients were analyzed, comparing outcomes between those who underwent PSE and those who did not. Of the 170 patients who received PSE, 14 (8.2%) had malignant port site involvement. Recurrence rates were comparable between the PSE and non-PSE groups (36% vs. 40%). Although the median overall survival was numerically higher in the PSE group (36-89 months vs. 30-45 months), this difference was not statistically significant.
Conclusion:
Routine PSE during CEC for iGBC may not be necessary, as it does not significantly reduce distant recurrence or improve overall survival.
