Łukasz Masior, Maciej Krasnodębski, Emilia Kruk, Martín de Santibañes, Pedro Uad, Juan Ramos, Michał Pędziwiatr, Wojciech Serednicki, Gilton Marques Fonseca, Paulo Herman, Robert P Sutcliffe, Ravi Marudanayagam, Alessandro Parente, Arianeb Mehrabi, Ali Ramouz, Peter Lodge, Keyur Shah, Hauke Lang, Constantin Scholz, Ganesh Gunasekaran, Nazanin Khajoueinejad, Samantha Troob, Marek Krawczyk, Michał Grąt
{"title":"Open versus laparoscopic oncologic resection for gallbladder cancer after index cholecystectomy: international multicenter comparative study.","authors":"Łukasz Masior, Maciej Krasnodębski, Emilia Kruk, Martín de Santibañes, Pedro Uad, Juan Ramos, Michał Pędziwiatr, Wojciech Serednicki, Gilton Marques Fonseca, Paulo Herman, Robert P Sutcliffe, Ravi Marudanayagam, Alessandro Parente, Arianeb Mehrabi, Ali Ramouz, Peter Lodge, Keyur Shah, Hauke Lang, Constantin Scholz, Ganesh Gunasekaran, Nazanin Khajoueinejad, Samantha Troob, Marek Krawczyk, Michał Grąt","doi":"10.1007/s00423-025-03643-6","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusions: </strong>Laparoscopic approach is feasible in patients with gallbladder cancer and may shorten the duration of hospital stay.</p><p><strong>Synopsis: </strong>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.</p>","PeriodicalId":17983,"journal":{"name":"Langenbeck's Archives of Surgery","volume":"410 1","pages":"74"},"PeriodicalIF":2.1000,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11832698/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Langenbeck's Archives of Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00423-025-03643-6","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
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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.
期刊介绍：
Langenbeck''s Archives of Surgery aims to publish the best results in the field of clinical surgery and basic surgical research. The main focus is on providing the highest level of clinical research and clinically relevant basic research. The journal, published exclusively in English, will provide an international discussion forum for the controlled results of clinical surgery. The majority of published contributions will be original articles reporting on clinical data from general and visceral surgery, while endocrine surgery will also be covered. Papers on basic surgical principles from the fields of traumatology, vascular and thoracic surgery are also welcome. Evidence-based medicine is an important criterion for the acceptance of papers.
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