Open versus laparoscopic oncologic resection for gallbladder cancer after index cholecystectomy: international multicenter comparative study
Masior, Łukasz Krasnodębski, Maciej Kruk, Emilia de Santibañes, Martín Uad, Pedro Ramos, Juan Pędziwiatr, Michał Serednicki, Wojciech Fonseca, Gilton Marques Herman, Paulo
Masior, Łukasz
Krasnodębski, Maciej
Kruk, Emilia
de Santibañes, Martín
Uad, Pedro
Ramos, Juan
Pędziwiatr, Michał
Serednicki, Wojciech
Fonseca, Gilton Marques
Herman, Paulo
Affiliation
Medical University of Warsaw; Hospital Italiano de Buenos Aires; Jagiellonian University Medical College; University of Sao Paulo; University Hospitals Birmingham NHS Foundation Trust; University of Birmingham; University of Heidelberg; Leeds Teaching Hospitals NHS Trust; University Medical Center of the Johannes Gutenberg-University Mainz; Mount Sinai Hospital
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Publication date
2025-02-17
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Abstract
Background: Liver resection and lymphadenectomy is a standard procedure in patients with incidental gallbladder cancer. Data regarding laparoscopic approach in this setting are scarce. The aim of this study was to compare laparoscopic and open approach in this population.
Methods: This was a multicenter retrospective study including 177 patients. The primary outcome measure was overall survival (OS). The secondary outcomes measures were recurrence-free survival (RFS), lymph node yield, operative time, postoperative complications and length of hospital stay.
Results: Surgery was laparoscopic in 60 (33.9%), including 18 conversions (30.0%). By intention to treat analysis, 3 and 5 year OS were 72.1% and 51.8% after laparoscopic surgery compared to 62.8% and 36.2% after open surgery (p = 0.201). 3- and 5-year RFS were 29.1% and 19.4% after laparoscopic surgery and 28.7% and 19.1% after open surgery (p = 0.697). Severe (grade ≥ 3 ) complications (p = 0.032) and Comprehensive Complication Index (CCI; p = 0.027) were both significantly higher after laparoscopic surgery (p = 0.032), although length of hospital stay was significantly shorter after laparoscopic procedures both on intention-to-treat (median 6 vs. 8 days; p = 0.004) and per protocol analysis (median 6 vs. 8 days; p = 0.004).
Conclusions: Laparoscopic approach is feasible in patients with gallbladder cancer and may shorten the duration of hospital stay.
Synopsis: This retrospective cohort study suggests that laparoscopic liver resection is feasible in patients with gallbladder cancer and may shorten the duration of hospital stay. Minimally invasive procedures should be performed by surgeons experienced in laparoscopic liver surgery.
Citation
Masior Ł, Krasnodębski M, Kruk E, de Santibañes M, Uad P, Ramos J, Pędziwiatr M, Serednicki W, Fonseca GM, Herman P, Sutcliffe RP, Marudanayagam R, Parente A, Mehrabi A, Ramouz A, Lodge P, Shah K, Lang H, Scholz C, Gunasekaran G, Khajoueinejad N, Troob S, Krawczyk M, Grąt M. Open versus laparoscopic oncologic resection for gallbladder cancer after index cholecystectomy: international multicenter comparative study. Langenbecks Arch Surg. 2025 Feb 17;410(1):74. doi: 10.1007/s00423-025-03643-6.
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Article