Novel strategy for laparoscopic treatment of pT2 gallbladder carcinoma

Osamu Itano, Go Oshima, Takuya Minagawa, Masahiro Shinoda, Minoru Kitago, Yuta Abe, Taizo Hibi, Hiroshi Yagi, Naruhiko Ikoma, Satoshi Aiko, Miho Kawaida, Yohei Masugi, Kaori Kameyama, Michiie Sakamoto, Yuukou Kitagawa

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Background: This study evaluated our new strategy for treating suspected T2 gallbladder carcinoma (GBC) using a laparoscopic approach.

Methods: We examined 19 patients with suspected T2 GBC who were treated laparoscopically (LS group) between December 2007 and December 2013; these patients were compared with 14 patients who underwent open surgery (OS group). Laparoscopic staging was initially performed to exclude factors making the patients ineligible for curative resection. Intraoperative pathological examination of the surgical margin of the cystic duct was performed prior to laparoscopic gallbladder bed resection, and pathological examination was again performed to confirm the presence of carcinoma and the depth of tumor invasion. Surgery was completed when the pathological findings indicated that the patient was cancer free. Lymph node dissection was performed according to the depth of tumor invasion.

Results: None of the patients required conversion to laparotomy. For three patients with benign lesions, only gallbladder bed resection was required. Additional regional lymph node dissection was performed in 16 patients in the LS group. The mean operative time (309 vs. 324 min, p = 0.755) and mean number of dissected lymph nodes (12.6 vs. 10.2, p = 0.361) were not significantly different between the LS and OS groups. The intraoperative blood loss was significantly lower (104 vs. 584 mL, p = 0.002) and the postoperative hospital stay was significantly shorter (9.1 vs. 21.6 days, p = 0.002) for LS patients than for those in the OS group. In the LS group, one patient developed postoperative pneumonia, but all patients survived without recurrence after a mean follow-up of 37 months.

Conclusion: Our strategy for suspected T2 gallbladder GBC is safe and useful, avoids unnecessary procedures, and is associated with similar oncologic outcomes as the open method.

Original languageEnglish
JournalSurgical Endoscopy and Other Interventional Techniques
DOIs
Publication statusAccepted/In press - 2015 Mar 5

Fingerprint

Gallbladder
Carcinoma
Therapeutics
Lymph Node Excision
Unnecessary Procedures
Cystic Duct
Neoplasms
Operative Time
Laparotomy
Length of Stay
Pneumonia
Lymph Nodes
Recurrence

Keywords

  • EUS
  • Gallbladder bed resection
  • Gallbladder carcinoma
  • Laparoscopic resection
  • Lymphadenectomy

ASJC Scopus subject areas

  • Surgery

Cite this

@article{acd57ff7c9664fb4a9225c4e1bc85739,
title = "Novel strategy for laparoscopic treatment of pT2 gallbladder carcinoma",
abstract = "Background: This study evaluated our new strategy for treating suspected T2 gallbladder carcinoma (GBC) using a laparoscopic approach.Methods: We examined 19 patients with suspected T2 GBC who were treated laparoscopically (LS group) between December 2007 and December 2013; these patients were compared with 14 patients who underwent open surgery (OS group). Laparoscopic staging was initially performed to exclude factors making the patients ineligible for curative resection. Intraoperative pathological examination of the surgical margin of the cystic duct was performed prior to laparoscopic gallbladder bed resection, and pathological examination was again performed to confirm the presence of carcinoma and the depth of tumor invasion. Surgery was completed when the pathological findings indicated that the patient was cancer free. Lymph node dissection was performed according to the depth of tumor invasion.Results: None of the patients required conversion to laparotomy. For three patients with benign lesions, only gallbladder bed resection was required. Additional regional lymph node dissection was performed in 16 patients in the LS group. The mean operative time (309 vs. 324 min, p = 0.755) and mean number of dissected lymph nodes (12.6 vs. 10.2, p = 0.361) were not significantly different between the LS and OS groups. The intraoperative blood loss was significantly lower (104 vs. 584 mL, p = 0.002) and the postoperative hospital stay was significantly shorter (9.1 vs. 21.6 days, p = 0.002) for LS patients than for those in the OS group. In the LS group, one patient developed postoperative pneumonia, but all patients survived without recurrence after a mean follow-up of 37 months.Conclusion: Our strategy for suspected T2 gallbladder GBC is safe and useful, avoids unnecessary procedures, and is associated with similar oncologic outcomes as the open method.",
keywords = "EUS, Gallbladder bed resection, Gallbladder carcinoma, Laparoscopic resection, Lymphadenectomy",
author = "Osamu Itano and Go Oshima and Takuya Minagawa and Masahiro Shinoda and Minoru Kitago and Yuta Abe and Taizo Hibi and Hiroshi Yagi and Naruhiko Ikoma and Satoshi Aiko and Miho Kawaida and Yohei Masugi and Kaori Kameyama and Michiie Sakamoto and Yuukou Kitagawa",
year = "2015",
month = "3",
day = "5",
doi = "10.1007/s00464-015-4116-y",
language = "English",
journal = "Surgical Endoscopy and Other Interventional Techniques",
issn = "0930-2794",
publisher = "Springer New York",

}

TY - JOUR

T1 - Novel strategy for laparoscopic treatment of pT2 gallbladder carcinoma

AU - Itano, Osamu

AU - Oshima, Go

AU - Minagawa, Takuya

AU - Shinoda, Masahiro

AU - Kitago, Minoru

AU - Abe, Yuta

AU - Hibi, Taizo

AU - Yagi, Hiroshi

AU - Ikoma, Naruhiko

AU - Aiko, Satoshi

AU - Kawaida, Miho

AU - Masugi, Yohei

AU - Kameyama, Kaori

AU - Sakamoto, Michiie

AU - Kitagawa, Yuukou

PY - 2015/3/5

Y1 - 2015/3/5

N2 - Background: This study evaluated our new strategy for treating suspected T2 gallbladder carcinoma (GBC) using a laparoscopic approach.Methods: We examined 19 patients with suspected T2 GBC who were treated laparoscopically (LS group) between December 2007 and December 2013; these patients were compared with 14 patients who underwent open surgery (OS group). Laparoscopic staging was initially performed to exclude factors making the patients ineligible for curative resection. Intraoperative pathological examination of the surgical margin of the cystic duct was performed prior to laparoscopic gallbladder bed resection, and pathological examination was again performed to confirm the presence of carcinoma and the depth of tumor invasion. Surgery was completed when the pathological findings indicated that the patient was cancer free. Lymph node dissection was performed according to the depth of tumor invasion.Results: None of the patients required conversion to laparotomy. For three patients with benign lesions, only gallbladder bed resection was required. Additional regional lymph node dissection was performed in 16 patients in the LS group. The mean operative time (309 vs. 324 min, p = 0.755) and mean number of dissected lymph nodes (12.6 vs. 10.2, p = 0.361) were not significantly different between the LS and OS groups. The intraoperative blood loss was significantly lower (104 vs. 584 mL, p = 0.002) and the postoperative hospital stay was significantly shorter (9.1 vs. 21.6 days, p = 0.002) for LS patients than for those in the OS group. In the LS group, one patient developed postoperative pneumonia, but all patients survived without recurrence after a mean follow-up of 37 months.Conclusion: Our strategy for suspected T2 gallbladder GBC is safe and useful, avoids unnecessary procedures, and is associated with similar oncologic outcomes as the open method.

AB - Background: This study evaluated our new strategy for treating suspected T2 gallbladder carcinoma (GBC) using a laparoscopic approach.Methods: We examined 19 patients with suspected T2 GBC who were treated laparoscopically (LS group) between December 2007 and December 2013; these patients were compared with 14 patients who underwent open surgery (OS group). Laparoscopic staging was initially performed to exclude factors making the patients ineligible for curative resection. Intraoperative pathological examination of the surgical margin of the cystic duct was performed prior to laparoscopic gallbladder bed resection, and pathological examination was again performed to confirm the presence of carcinoma and the depth of tumor invasion. Surgery was completed when the pathological findings indicated that the patient was cancer free. Lymph node dissection was performed according to the depth of tumor invasion.Results: None of the patients required conversion to laparotomy. For three patients with benign lesions, only gallbladder bed resection was required. Additional regional lymph node dissection was performed in 16 patients in the LS group. The mean operative time (309 vs. 324 min, p = 0.755) and mean number of dissected lymph nodes (12.6 vs. 10.2, p = 0.361) were not significantly different between the LS and OS groups. The intraoperative blood loss was significantly lower (104 vs. 584 mL, p = 0.002) and the postoperative hospital stay was significantly shorter (9.1 vs. 21.6 days, p = 0.002) for LS patients than for those in the OS group. In the LS group, one patient developed postoperative pneumonia, but all patients survived without recurrence after a mean follow-up of 37 months.Conclusion: Our strategy for suspected T2 gallbladder GBC is safe and useful, avoids unnecessary procedures, and is associated with similar oncologic outcomes as the open method.

KW - EUS

KW - Gallbladder bed resection

KW - Gallbladder carcinoma

KW - Laparoscopic resection

KW - Lymphadenectomy

UR - http://www.scopus.com/inward/record.url?scp=84924098690&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84924098690&partnerID=8YFLogxK

U2 - 10.1007/s00464-015-4116-y

DO - 10.1007/s00464-015-4116-y

M3 - Article

C2 - 25740638

AN - SCOPUS:84947493312

JO - Surgical Endoscopy and Other Interventional Techniques

JF - Surgical Endoscopy and Other Interventional Techniques

SN - 0930-2794

ER -