Laparoscopic radical cholecystectomy is worthwhile!

Abstract

Background: In this era of minimally invasive surgery, application of laparoscopic technique for the management of gallbladder cancer (GBC) is still evolving. This study was undertaken to determine the safety and feasibility of laparoscopic radical cholecystectomy (LRC) for GBC. Methods: Retrospective analysis of prospectively maintained data between June 2011 and July 2015. Of the 45 cases of LRC, 40 cases were GBC and 5 were xanthogranulomatous cholecystitis. Primary GBC patients with minimal liver infiltration and incidental GBC (IGBC) patients following laparoscopic cholecystectomy were considered for LRC. Standard radical cholecystectomy (resection of segments IVB and V) was performed with standard lymphadenectomy. All port sites were excised in IGBC patients. Results: 40 (31 primary GBC and 9 IGBC) underwent LRC during the study period for GBC. Median (range) operating time was 280(180–340), Median (range) blood loss was 180 (50–850), Morbidity include Grade A (ISGLS) bile leak in one patient, One had minor chyle leak and 2 patients had subhepatic collection. Median post-operative hospital stay was 5 days (range 3–16 days). Pathological T stage in primary GBC and IGBC patients were T1b in 6 and 3, T2 in 13 and 4and T3 in12 and 2. R0 resection was achieved in all patients. Median (range) lymph node yield was 12 (3–31) in GBC.All patients were alive and one showed recurrence. Conclusion: Laparoscopic radical cholecystectomy is safe and feasible in selected patients with primary and incidental GBC.