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Gastroenterology Research and Practice
Volume 2016, Article ID 7684915, 8 pages
http://dx.doi.org/10.1155/2016/7684915
Review Article

Current Role of Minimally Invasive Radical Cholecystectomy for Gallbladder Cancer

1Department of General Surgery, Istituto Ospedaliero Fondazione Poliambulanza, Via Bissolati n 57, Brescia, Italy
2Department of Oncology, Istituto Ospedaliero Fondazione Poliambulanza, Via Bissolati n 57, Brescia, Italy

Received 21 July 2016; Accepted 19 September 2016

Academic Editor: Emanuele Felli

Copyright © 2016 Giuseppe Zimmitti et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. For Tis and T1a gallbladder cancer (GbC), laparoscopic cholecystectomy can provide similar survival outcomes compared to open cholecystectomy. However, for patients affected by resectable T1b or more advanced GbC, open approach radical cholecystectomy (RC), consisting in gallbladder liver bed resection or segment 4b-5 bisegmentectomy, with locoregional lymphadenectomy, is considered the gold standard while minimally invasive RC (MiRC) is skeptically considered. Aim. To analyze current literature on perioperative and oncologic outcomes of MiRC for patients affected by GbC. Methods. A Medline review of published articles until June 2016 concerning MiRC for GbC was performed. Results. Data relevant for this review were presented in 13 articles, including 152 patients undergoing an attempt of MiRC for GbC. No randomized clinical trial was found. The approach was laparoscopic in 147 patients and robotic in five. Conversion was required in 15 (10%) patients. Postoperative complications rate was 10% with no mortality. Long-term survival outcomes were reported by 11 studies, two of them showing similar oncologic results when comparing MiRC with matched open RC. Conclusions. Although randomized clinical trials are still lacking and only descriptive studies reporting on limited number of patients are available, current literature seems suggesting that when performed at highly specialized centers, MiRC for GbC is safe and feasible and has oncologic outcomes comparable to open RC.