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Laparoscopy versus laparotomy approach of a radical resection for gallbladder cancer: a retrospective comparative study

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Abstract

Background

Laparoscopic approach for gallbladder cancer (GBC) has long been contraindicated, but few recent studies have demonstrated the oncologic outcomes of this treatment. The purpose of this study was to compare the perioperative outcomes and long-term survival for laparoscopic surgery versus traditional open surgery of GBC.

Method

Between January 2014 and December 2018, 63 GBC patients who received radical resection were enrolled in this study, with 32 patients in laparoscopic group and 31 cases in laparotomy group. Perioperative data and postoperative survival were retrospectively evaluated.

Results

Laparoscopic approach was associated with less intraoperative bleeding (267.20 ± 47.07 vs. 502.60 ± 69.70, P = 0.007), fewer postoperative days of oral diet recovery (2.34 ± 0.31 vs. 3.32 ± 0.35, P = 0.041), and hospital stay (11.03 ± 0.99 vs. 14.35 ± 1.11, P = 0.028). There were no significant differences between two groups regarding other perioperative outcomes. Patients in laparoscopic group showed better 1-year overall survival than those in laparotomy group (72.91% vs. 47.82%, P = 0.086). Subgroup analysis for GBC patients in T3 stages revealed that laparoscopic approach was associated with less intraoperative bleeding (268.00 ± 57.19 vs. 541.50 ± 101.30, P = 0.009), fewer postoperative days of hospital stay (9.87 ± 1.10 vs. 14.90 ± 1.53, P = 0.017), and improved 1-year overall survival (P = 0.023). Subgroup analysis for GBCs in TNM III and TNM IV stages showed comparable intraoperative parameters and postoperative survival between two groups.

Conclusion

Laparoscopic surgery for GBCs may offer the comparable perioperative outcomes as conventional laparotomy procedure, and tend to be associated with less intraoperative bleeding, faster oral diet recovery, shorter hospital stay, and improved 1-year overall survival.

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Authors and Affiliations

  1. Department of Hepatobiliary, Pancreatic and Minimal Invasive Surgery, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical College, No. 158 of Shangtang Road, Hangzhou, 310014, Zhejiang, China

    Changwei Dou, Yuhua Zhang, Jie Liu, Fangqiang Wei, Hongwu Chu, Junjun Han, Qifeng Yao, Jianyi Ding & Chengwu Zhang

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  1. Changwei Dou
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  2. Yuhua Zhang
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  3. Jie Liu
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  5. Hongwu Chu
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  9. Chengwu Zhang
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Correspondence to Chengwu Zhang.

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All authors including Dr. Changwei Dou, Dr. Yuhua Zhang, Dr. Jie Liu, Dr. Fangqiang Wei, Dr. Hongwu Chu, Dr. Junjun Han, Dr. Qifeng Yao, Dr. Jianyi Ding, and Dr. Chengwu Zhang have no conflicts of interest or financial ties to disclose.

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Dou, C., Zhang, Y., Liu, J. et al. Laparoscopy versus laparotomy approach of a radical resection for gallbladder cancer: a retrospective comparative study. Surg Endosc 34, 2926–2938 (2020). https://doi.org/10.1007/s00464-019-07075-4

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  • DOI: https://doi.org/10.1007/s00464-019-07075-4

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