Sun J, Xie TG, Ma ZY, Wu X, Li BL. Current status and progress in laparoscopic surgery for gallbladder carcinoma. World J Gastroenterol 2023; 29(16): 2369-2379 [PMID: 37179580 DOI: 10.3748/wjg.v29.i16.2369]
Corresponding Author of This Article
Bing-Lu Li, MD, PhD, Doctor, Professor, Department of General Surgery, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, No. 1 Shuaifuyuan, Wangfujing, Dongcheng District, Beijing 100730, China. pumchlbl@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Opinion Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Apr 28, 2023; 29(16): 2369-2379 Published online Apr 28, 2023. doi: 10.3748/wjg.v29.i16.2369
Current status and progress in laparoscopic surgery for gallbladder carcinoma
Jia Sun, Tian-Ge Xie, Zu-Yi Ma, Xin Wu, Bing-Lu Li
Jia Sun, Tian-Ge Xie, Zu-Yi Ma, Xin Wu, Bing-Lu Li, Department of General Surgery, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100730, China
Author contributions: All authors contributed to the preparation of manuscript, literature search, and review of the manuscript.
Supported byChinese Academy of Medical Sciences Innovation Fund for Medical Sciences, No. 2022-I2M-C&T-A-004; and National High Level Hospital Clinical Research Funding, No. 2022-PUMCH-B-005.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Bing-Lu Li, MD, PhD, Doctor, Professor, Department of General Surgery, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, No. 1 Shuaifuyuan, Wangfujing, Dongcheng District, Beijing 100730, China. pumchlbl@163.com
Received: November 28, 2022 Peer-review started: November 28, 2022 First decision: January 23, 2023 Revised: February 1, 2023 Accepted: April 7, 2023 Article in press: April 7, 2023 Published online: April 28, 2023
Abstract
Gallbladder carcinoma (GBC) is the most common biliary tract malignancy associated with a concealed onset, high invasiveness and poor prognosis. Radical surgery remains the only curative treatment for GBC, and the optimal extent of surgery depends on the tumor stage. Radical resection can be achieved by simple cholecystectomy for Tis and T1a GBC. However, whether simple cholecystectomy or extended cholecystectomy, including regional lymph node dissection and hepatectomy, is the standard surgical extent for T1b GBC remains controversial. Extended cholecystectomy should be performed for T2 and some T3 GBC without distant metastasis. Secondary radical surgery is essential for incidental gall-bladder cancer diagnosed after cholecystectomy. For locally advanced GBC, hepatopancreatoduodenectomy may achieve R0 resection and improve long-term survival outcomes, but the extremely high risk of the surgery limits its implementation. Laparoscopic surgery has been widely used in the treatment of gastrointestinal malignancies. GBC was once regarded as a contraindication of laparoscopic surgery. However, with improvements in surgical instruments and skills, studies have shown that laparoscopic surgery will not result in a poorer prognosis for selected patients with GBC compared with open surgery. Moreover, laparoscopic surgery is associated with enhanced recovery after surgery since it is minimally invasive.
Core Tip: Gallbladder carcinoma (GBC) is the most common biliary tract malignancy with a poor prognosis. Radical surgery is the mainstay of treatment, and the surgical extent depends on the tumor stage. Meanwhile, laparoscopic surgery has the advantage of enhanced recovery after surgery because it is minimally invasive, and has been widely used to treat gastrointestinal malignancies. Although GBC was once regarded as a contraindication for laparoscopic surgery, with improved surgical instruments and skills, recent studies have shown that laparoscopic surgery will not lead to a poorer prognosis compared with open surgery among selected patients with GBC in specialized centers.
