Management of primary gallbladder cancer by combining laparoscopy and open surgery / 中国微创外科杂志

ABSTRACT

Objective To explore the method and the effect of combined use of laparoscopy and open surgery in the treatment of primary gallbladder cancer. Methods Pathological frozen-section examinations were carried out in all cases suspected of gallbladder cancer during laparoscopic cholecystectomy (LC). Patients in Ⅰ～Ⅱ Nevin stage received surgical removal of loose connective tissue at hepatic portal and gallbladder bed under laparoscope, while patients in stage Ⅲ or above underwent conversions to open operations of radical or extended radical resections. Results Out of the 34 cases of gallbladder cancer receiving LC, conversions to open surgery were required in 6 cases, open operations were performed after laparoscopic operation in 7 cases, and 1 patient refused further treatment. Except for 1 case of port-site cancer implantation below the xiphoid process, no other severe intra- or post- operative complications occurred. Follow-up revealed a 5-year survival rate of 80% (12/15) (survival range, 2～8 years) in 15 cases of laparoscopic surgery, and a survival duration of 8 months～4 years in 8 cases of open surgery. Conclusions Combined use of laparoscopy and open surgery in the management of variable stages of primary gallbladder cancer is effective.