Laparoscopic radical cholecystectomy vs open surgery for T2 gallbladder cancer

Abstract

Objective To evaluate laparoscopic radical cholecystectomy for T2 gallbladder cancers. Methods A retrospective analysis was made on 44 patients with pathology confirmed T2 gallbladder cancer undergoing laparoscopic vs open radical cholecystectomy. The clinicopathological and follow-up data were compared. Results Laparoscopic cholecystectomy was performed in 32 patients, the implantation metastasis rate of this approach has no statistical differences compared with the open cholecystectomy(P=1.000). 26 patients underwent laparoscopic radical resection and the remaining 18 patients underwent open radical resection. There was no statistical difference in operation time (P=0.953), blood loss (P=0.193) and postoperative complications (P=1.000), but the laparoscopic radical resection group is superior to the open group on postoperative pain grading (P=0.022), ambulation time (P=0.000), nothing per mouth time (P=0.000) and length of hospital stay (P=0.048). The mean number of lymph nodes retrieved was 5±4 (range 1-12) in the laparoscopic radical group and 6±3 (range 1-12) in the open group (P=0.983); the 1, 3, 5 year survival rates was 92.3%, 70.3%, 61.5% and 92.3%, 76.3%, 69.3%, respectively(P=0.473). Conclusions Initial laparoscopic cholecystectomy does not increase the rate of seeding metastasis in the context of intact gallbladder carcinoma. Totall laparoscopic radical resection is feasible in selected T2 gallbladder cancer patients. Key words: Gallbladder neoplasms; Cholecystectomy, laparoscopic