Long-term efficacy of laparoscopic cholecystectomy for gallbladder cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

WU Xin ,  HONG Tao , LI Binglu , ZHENG Chaoji , LIU Wei , HE Xiaodong

Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, P. R. China;

Corresponding author：

HONG Tao, Email: hongtaopumch@163.com

Keywords：

gallbladder cancer; laparoscopic cholecystectomy; T1a stage; prognosis

DOI：

10.7507/1007-9424.201909106

Video：

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Objective To investigate the long-term efficacy of laparoscopic cholecystectomy (LC) for gallbladder cancer.Method The clinical data of 52 patients with gallbladder cancer only underwent LC from January 1998 to December 2018 in the Peking Union Medical College Hospital were analyzed retrospectively.Results Fifty-two patients met the inclusion criteria were included, including 23 males and 29 females. The age was (67±12) years. Fifty-two patients were treated with LC because of gallbladder occupying or gallstone. Twenty-three patients were diagnosed as incidental gallbladder cancer after the surgery, while 29 patients were diagnosed as the gallbladder cancer before or during the operation. Eleven patients with T1a lesions received the close follow-up, the other 41 patients refused the radical operation due to the advanced age, severe underlying diseases or their own preferences. Five cases of postoperative complications were observed. All patients were followed-up for (40.2±33.8) months, 21 patients survived and 31 died. The dead patients had an older age, longer hospital stays, and later T stage (P<0.050) as compared with the living patients. The patients with T1a lesions had significantly longer survival time than those with T1b and above (113.5 months versus 39.6 months, P<0.001).Conclusions LC is a radical operation in T1a lesions. At the same time, it can meet the requirements of postoperative life quality for some special patients due to its safety and low postoperative complication rate.

Citation： WU Xin, HONG Tao, LI Binglu, ZHENG Chaoji, LIU Wei, HE Xiaodong. Long-term efficacy of laparoscopic cholecystectomy for gallbladder cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2020, 27(6): 714-717. doi: 10.7507/1007-9424.201909106 Copy

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3.	Sachs TE, Akintorin O, Tseng J. How should gallbladder cancer be managed? Adv Surg, 2018, 52(1): 89-100.
4.	Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6 336 patients and results of a survey. Ann Surg, 2004, 240(2): 205-213.
5.	Kasumova GG, Tabatabaie O, Najarian RM, et al. Surgical management of gallbladder cancer: simple versus extended cholecystectomy and the role of adjuvant therapy. Ann Surg, 2017, 266(4): 625-631.
6.	Duffy A, Capanu M, Abou-Alfa GK, et al. Gallbladder cancer (GBC): 10-year experience at Memorial Sloan-Kettering Cancer Centre (MSKCC). J Surg Oncol, 2008, 98(7): 485-489.
7.	Aloia TA, Járufe N, Javle M, et al. Gallbladder cancer: expert consensus statement. HPB (Oxford), 2015, 17(8): 681-690.
8.	Ethun CG, Postlewait LM, Le N, et al. Association of optimal time interval to re-resection for incidental gallbladder cancer with overall survival: a multi-institution analysis from the US extrahepatic biliary malignancy consortium. JAMA Surg, 2017, 152(2): 143-149.
9.	Ball CG. Damage control surgery. Curr Opin Crit Care, 2015, 21(6): 538-543.
10.	Benz D, Balogh ZJ. Damage control surgery: current state and future directions. Curr Opin Crit Care, 2017, 23(6): 491-497.
11.	Jemal A, Siegel R, Xu J, et al. Cancer statistics, 2010. CA Cancer J Clin, 2010, 60(5): 277-300.
12.	Clark OH, Benson AB 3rd, Berlin JD, et al. NCCN clinical practice guidelines in oncology: neuroendocrine tumors. J Natl Compr Canc Netw, 2009, 7(7): 712-747.
13.	AJCC. Gallbladder (chapter 24)//Zhu AX, Pawlik TM, Kooby DA, et al. AJCC Cancer Staging Manual. 8th edition. New York: Springer, 2018: 303-309.
14.	Shukla SK, Singh G, Shahi KS, et al. Staging, treatment, and future approaches of gallbladder carcinoma. J Gastrointest Cancer, 2018, 49(1): 9-15.
15.	Hawkins WG, DeMatteo RP, Jarnagin WR, et al. Jaundice predicts advanced disease and early mortality in patients with gallbladder cancer. Ann Surg Oncol, 2004, 11(3): 310-315.
16.	Fong Y, Jarnagin W, Blumgart LH. Gallbladder cancer: comparison of patients presenting initially for definitive operation with those presenting after prior noncurative intervention. Ann Surg, 2000, 232(4): 557-569.
17.	Chan SY, Poon RT, Lo CM, et al. Management of carcinoma of the gallbladder: a single-institution experience in 16 years. J Surg Oncol, 2008, 97(2): 156-164.
18.	Chijiiwa K, Noshiro H, Nakano K, et al. Role of surgery for gallbladder carcinoma with special reference to lymph node metastasis and stage using western and Japanese classification systems. World J Surg, 2000, 24(10): 1271-1276.
19.	Kayahara M, Nagakawa T, Nakagawara H, et al. Prognostic factors for gallbladder cancer in Japan. Ann Surg, 2008, 248(5): 807-814.
20.	Konstantinidis IT, Deshpande V, Genevay M, et al. Trends in presentation and survival for gallbladder cancer during a period of more than 4 decades: a single-institution experience. Arch Surg, 2009, 144(5): 441-447.

1. Wernberg JA, Lucarelli DD. Gallbladder cancer. Surg Clin North Am, 2014, 94(2): 343-360.
2. Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015. CA Cancer J Clin, 2016, 66(2): 115-132.
3. Sachs TE, Akintorin O, Tseng J. How should gallbladder cancer be managed? Adv Surg, 2018, 52(1): 89-100.
4. Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6 336 patients and results of a survey. Ann Surg, 2004, 240(2): 205-213.
5. Kasumova GG, Tabatabaie O, Najarian RM, et al. Surgical management of gallbladder cancer: simple versus extended cholecystectomy and the role of adjuvant therapy. Ann Surg, 2017, 266(4): 625-631.
6. Duffy A, Capanu M, Abou-Alfa GK, et al. Gallbladder cancer (GBC): 10-year experience at Memorial Sloan-Kettering Cancer Centre (MSKCC). J Surg Oncol, 2008, 98(7): 485-489.
7. Aloia TA, Járufe N, Javle M, et al. Gallbladder cancer: expert consensus statement. HPB (Oxford), 2015, 17(8): 681-690.
8. Ethun CG, Postlewait LM, Le N, et al. Association of optimal time interval to re-resection for incidental gallbladder cancer with overall survival: a multi-institution analysis from the US extrahepatic biliary malignancy consortium. JAMA Surg, 2017, 152(2): 143-149.
9. Ball CG. Damage control surgery. Curr Opin Crit Care, 2015, 21(6): 538-543.
10. Benz D, Balogh ZJ. Damage control surgery: current state and future directions. Curr Opin Crit Care, 2017, 23(6): 491-497.
11. Jemal A, Siegel R, Xu J, et al. Cancer statistics, 2010. CA Cancer J Clin, 2010, 60(5): 277-300.
12. Clark OH, Benson AB 3rd, Berlin JD, et al. NCCN clinical practice guidelines in oncology: neuroendocrine tumors. J Natl Compr Canc Netw, 2009, 7(7): 712-747.
13. AJCC. Gallbladder (chapter 24)//Zhu AX, Pawlik TM, Kooby DA, et al. AJCC Cancer Staging Manual. 8th edition. New York: Springer, 2018: 303-309.
14. Shukla SK, Singh G, Shahi KS, et al. Staging, treatment, and future approaches of gallbladder carcinoma. J Gastrointest Cancer, 2018, 49(1): 9-15.
15. Hawkins WG, DeMatteo RP, Jarnagin WR, et al. Jaundice predicts advanced disease and early mortality in patients with gallbladder cancer. Ann Surg Oncol, 2004, 11(3): 310-315.
16. Fong Y, Jarnagin W, Blumgart LH. Gallbladder cancer: comparison of patients presenting initially for definitive operation with those presenting after prior noncurative intervention. Ann Surg, 2000, 232(4): 557-569.
17. Chan SY, Poon RT, Lo CM, et al. Management of carcinoma of the gallbladder: a single-institution experience in 16 years. J Surg Oncol, 2008, 97(2): 156-164.
18. Chijiiwa K, Noshiro H, Nakano K, et al. Role of surgery for gallbladder carcinoma with special reference to lymph node metastasis and stage using western and Japanese classification systems. World J Surg, 2000, 24(10): 1271-1276.
19. Kayahara M, Nagakawa T, Nakagawara H, et al. Prognostic factors for gallbladder cancer in Japan. Ann Surg, 2008, 248(5): 807-814.
20. Konstantinidis IT, Deshpande V, Genevay M, et al. Trends in presentation and survival for gallbladder cancer during a period of more than 4 decades: a single-institution experience. Arch Surg, 2009, 144(5): 441-447.

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Long-term efficacy of laparoscopic cholecystectomy for gallbladder cancer

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