NDLI: Minimally invasive versus the conventional open surgical approach of a radical cholecystectomy for gallbladder cancer: a retrospective comparative study.

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Minimally invasive versus the conventional open surgical approach of a radical cholecystectomy for gallbladder cancer: a retrospective comparative study.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Agarwal, Anil K. Javed, Amit Kalayarasan, Raja Sakhuja, Puja
Description	Country affiliation: India Author Affiliation: Agarwal AK ( Department of Gastrointestinal Surgery, GB Pant Hospital & MAM College, Delhi University, New Delhi, India.); Javed A ( Department of Gastrointestinal Surgery, GB Pant Hospital & MAM College, Delhi University, New Delhi, India.); Kalayarasan R ( Department of Gastrointestinal Surgery, GB Pant Hospital & MAM College, Delhi University, New Delhi, India.); Sakhuja P ( Department of Pathology, GB Pant Hospital & MAM College, Delhi University, New Delhi, India.)
Abstract	BACKGROUND: Laparoscopic surgery has traditionally been contraindicated for the management of gall bladder cancer (GBC). This study was undertaken to determine the safety and feasibility of a laparoscopic radical cholecystectomy (LRC) for GBC and compare it with an open radical cholecystectomy (ORC). METHODS: Retrospective analysis of primary GBC patients (with limited liver infiltration) and incidental GBC (IGBC) patients (detected after a laparoscopic cholecystectomy) who underwent LRC between June 2011 and October 2013. Patients who fulfilled the study criteria and underwent ORC during the same period formed the control group. RESULTS: During the study period, 147 patients with GBC underwent a radical cholecystectomy. Of these, 24 patients (primary GBC- 20, IGBC - 4) who underwent a LRC formed the study group (Group A). Of the remaining 123 patients who underwent ORC, 46 matched patients formed the control group (Group B). The median operating time was higher in Group A (270 versus 240 mins, P = 0.021) and the median blood loss (ml) was lower (200 versus 275 ml, P = 0.034). The post-operative morbidity and mortality were similar (P = 1.0). The pathological stage of the tumour in Group A was T1b (n = 1), T2 (n = 11) and T3 (n = 8), respectively. The median lymph node yield was 10 (4-31) and was comparable between the two groups (P = 0.642). During a median follow-up of 18 (6-34) months, 1 patient in Group A and 3 in Group B developed recurrence. No patient developed a recurrence at a port site. CONCLUSION: LRC is safe and feasible in selected patients with GBC, and the results were comparable to ORC in this retrospective comparison.
File Format	HTM / HTML
ISSN	1365182X
e-ISSN	14772574
DOI	10.1111/hpb.12406
Journal	HPB
Issue Number	6
Volume Number	17
Language	English
Publisher	Elsevier
Publisher Date	2015-06-01
Publisher Place	Great Britain (UK)
Access Restriction	Open
Subject Keyword	Discipline Gastroenterology Cholecystectomy, Laparoscopic Cholecystectomy Gallbladder Neoplasms Surgery Blood Loss, Surgical Adverse Effects Mortality Feasibility Studies Pathology Lymph Node Excision Lymphatic Metastasis Neoplasm Staging Operative Time Retrospective Studies Risk Factors Time Factors Comparative Study
Content Type	Text
Resource Type	Article
Subject	Hepatology Gastroenterology

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