Current Role of Minimally Invasive Radical Cholecystectomy for Gallbladder Cancer

Background. For Tis and T1a gallbladder cancer (GbC), laparoscopic cholecystectomy can provide similar survival outcomes compared to open cholecystectomy. However, for patients affected by resectable T1b or more advanced GbC, open approach radical cholecystectomy (RC), consisting in gallbladder live...

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Main Authors: Giuseppe Zimmitti, Alberto Manzoni, Francesca Guerini, Marco Ramera, Paola Bertocchi, Francesca Aroldi, Alberto Zaniboni, Edoardo Rosso
Format: Article
Language:English
Published: Wiley 2016-01-01
Series:Gastroenterology Research and Practice
Online Access:http://dx.doi.org/10.1155/2016/7684915
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author Giuseppe Zimmitti
Alberto Manzoni
Francesca Guerini
Marco Ramera
Paola Bertocchi
Francesca Aroldi
Alberto Zaniboni
Edoardo Rosso
author_facet Giuseppe Zimmitti
Alberto Manzoni
Francesca Guerini
Marco Ramera
Paola Bertocchi
Francesca Aroldi
Alberto Zaniboni
Edoardo Rosso
author_sort Giuseppe Zimmitti
collection DOAJ
description Background. For Tis and T1a gallbladder cancer (GbC), laparoscopic cholecystectomy can provide similar survival outcomes compared to open cholecystectomy. However, for patients affected by resectable T1b or more advanced GbC, open approach radical cholecystectomy (RC), consisting in gallbladder liver bed resection or segment 4b-5 bisegmentectomy, with locoregional lymphadenectomy, is considered the gold standard while minimally invasive RC (MiRC) is skeptically considered. Aim. To analyze current literature on perioperative and oncologic outcomes of MiRC for patients affected by GbC. Methods. A Medline review of published articles until June 2016 concerning MiRC for GbC was performed. Results. Data relevant for this review were presented in 13 articles, including 152 patients undergoing an attempt of MiRC for GbC. No randomized clinical trial was found. The approach was laparoscopic in 147 patients and robotic in five. Conversion was required in 15 (10%) patients. Postoperative complications rate was 10% with no mortality. Long-term survival outcomes were reported by 11 studies, two of them showing similar oncologic results when comparing MiRC with matched open RC. Conclusions. Although randomized clinical trials are still lacking and only descriptive studies reporting on limited number of patients are available, current literature seems suggesting that when performed at highly specialized centers, MiRC for GbC is safe and feasible and has oncologic outcomes comparable to open RC.
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spelling doaj-art-efd14f308fca4747bad953d9eb2bd2282025-08-20T03:06:27ZengWileyGastroenterology Research and Practice1687-61211687-630X2016-01-01201610.1155/2016/76849157684915Current Role of Minimally Invasive Radical Cholecystectomy for Gallbladder CancerGiuseppe Zimmitti0Alberto Manzoni1Francesca Guerini2Marco Ramera3Paola Bertocchi4Francesca Aroldi5Alberto Zaniboni6Edoardo Rosso7Department of General Surgery, Istituto Ospedaliero Fondazione Poliambulanza, Via Bissolati n 57, Brescia, ItalyDepartment of General Surgery, Istituto Ospedaliero Fondazione Poliambulanza, Via Bissolati n 57, Brescia, ItalyDepartment of General Surgery, Istituto Ospedaliero Fondazione Poliambulanza, Via Bissolati n 57, Brescia, ItalyDepartment of General Surgery, Istituto Ospedaliero Fondazione Poliambulanza, Via Bissolati n 57, Brescia, ItalyDepartment of Oncology, Istituto Ospedaliero Fondazione Poliambulanza, Via Bissolati n 57, Brescia, ItalyDepartment of Oncology, Istituto Ospedaliero Fondazione Poliambulanza, Via Bissolati n 57, Brescia, ItalyDepartment of Oncology, Istituto Ospedaliero Fondazione Poliambulanza, Via Bissolati n 57, Brescia, ItalyDepartment of General Surgery, Istituto Ospedaliero Fondazione Poliambulanza, Via Bissolati n 57, Brescia, ItalyBackground. For Tis and T1a gallbladder cancer (GbC), laparoscopic cholecystectomy can provide similar survival outcomes compared to open cholecystectomy. However, for patients affected by resectable T1b or more advanced GbC, open approach radical cholecystectomy (RC), consisting in gallbladder liver bed resection or segment 4b-5 bisegmentectomy, with locoregional lymphadenectomy, is considered the gold standard while minimally invasive RC (MiRC) is skeptically considered. Aim. To analyze current literature on perioperative and oncologic outcomes of MiRC for patients affected by GbC. Methods. A Medline review of published articles until June 2016 concerning MiRC for GbC was performed. Results. Data relevant for this review were presented in 13 articles, including 152 patients undergoing an attempt of MiRC for GbC. No randomized clinical trial was found. The approach was laparoscopic in 147 patients and robotic in five. Conversion was required in 15 (10%) patients. Postoperative complications rate was 10% with no mortality. Long-term survival outcomes were reported by 11 studies, two of them showing similar oncologic results when comparing MiRC with matched open RC. Conclusions. Although randomized clinical trials are still lacking and only descriptive studies reporting on limited number of patients are available, current literature seems suggesting that when performed at highly specialized centers, MiRC for GbC is safe and feasible and has oncologic outcomes comparable to open RC.http://dx.doi.org/10.1155/2016/7684915
spellingShingle Giuseppe Zimmitti
Alberto Manzoni
Francesca Guerini
Marco Ramera
Paola Bertocchi
Francesca Aroldi
Alberto Zaniboni
Edoardo Rosso
Current Role of Minimally Invasive Radical Cholecystectomy for Gallbladder Cancer
Gastroenterology Research and Practice
title Current Role of Minimally Invasive Radical Cholecystectomy for Gallbladder Cancer
title_full Current Role of Minimally Invasive Radical Cholecystectomy for Gallbladder Cancer
title_fullStr Current Role of Minimally Invasive Radical Cholecystectomy for Gallbladder Cancer
title_full_unstemmed Current Role of Minimally Invasive Radical Cholecystectomy for Gallbladder Cancer
title_short Current Role of Minimally Invasive Radical Cholecystectomy for Gallbladder Cancer
title_sort current role of minimally invasive radical cholecystectomy for gallbladder cancer
url http://dx.doi.org/10.1155/2016/7684915
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