Laparoscopic cholecystectomy based on Laennec approach via the cystic plate with lymphadenectomy in Calot's triangle for gallbladder neoplasms: Initial experience and technical details

Abstract

BackgroundIt is still challenging to define the exact stage of early gallbladder carcinoma with preoperative imaging. Generally, subserous gallbladder is dissected for the potential early gallbladder carcinoma, which may cause incomplete tumor resection or tumor spread especially for the patients with T2 stage. Here, we reported our experience and safety of Laennec approach via the cystic plate to dissect the whole gallbladder with lymphadenectomy in Calot's triangle for accurate diagnosis and stage in gallbladder neoplasms. MethodsThe anatomical gap between Laennec capsule and the cystic plate serves as the landmark to dissect the whole gallbladder through Laennec approach. Laparoscopic cholecystectomy based on Laennec approach via the cystic plate, together with lymphadenectomy in Calot's triangle, was performed in 17 patients with gallbladder neoplasms. ResultsAll patients had less intraoperative bleeding, no gallbladder breakage, no bile leakage, and accurate intraoperative rapid pathological staging under the corresponding strategies. The duration of surgery was comparable to that of traditional laparoscopic cholecystectomy. ConclusionLaparoscopic cholecystectomy based on Laennec approach via the cystic plate, together with lymphadenectomy in Calot's triangular is safe for gallbladder neoplasms. In the future, the prospective clinical trial is going on to confirm the feasibility and effectiveness of this approach.