Published online Apr 14, 2017. doi: 10.3748/wjg.v23.i14.2556
Peer-review started: February 8, 2017
First decision: March 3, 2017
Revised: March 13, 2017
Accepted: March 20, 2017
Article in press: March 20, 2017
Published online: April 14, 2017
To evaluate a laparoscopic approach to gallbladder lesions including polyps, wall-thickening lesions, and suspected T1 and T2 gallbladder cancer (GBC).
We performed 50 cases of laparoscopic whole-layer cholecystectomy (LCWL) and 13 cases of laparoscopic gallbladder bed resection (LCGB) for those gallbladder lesions from April 2010 to November 2016. We analyzed the short-term and long-term results of our laparoscopic approach.
The median operation time was 108 min for LCWL and 211 min for LCGB. The median blood loss was minimal for LCWL and 28 ml for LCGB. No severe morbidity occurred in either procedure. Nine patients who underwent LCWL and 7 who underwent LCGB were postoperatively diagnosed with GBC. One of these patients had undergone LCGB for pathologically diagnosed T2 GBC after LCWL. All of the final surgical margins were negative. Three of these 15 patients underwent additional open surgery. The mean follow-up period was 26 mo, and only one patient developed recurrence.
LCWL and LCGB are safe and useful procedures that allow complete resection of highly suspected or early-stage cancer and achieve good short-term and long-term results.
Core tip: Laparoscopic cholecystectomy is commonly performed for the treatment of benign diseases. Gallbladder carcinoma (GBC) is typically managed by open surgery because of various concerns associated with potential dissemination, recurrence, and technical difficulties. However, many benign lesions are difficult to differentiate from GBC, including polyps and lesions that cause wall thickening. We use a laparoscopic approach for many types of gallbladder lesions including gallbladder carcinoma. This study demonstrated that our laparoscopic approach is safe, useful, and allows for the complete resection of highly suspected or early-stage gallbladder cancer.