ORIGINAL ARTICLES   

Minerva Chirurgica 2012 October;67(5):389-97

Copyright © 2012 EDIZIONI MINERVA MEDICA

language: English

Gallbladder neoplasm: a single institution experience according to the standard current management

Rossi M. ¹, Bencini L. ², Calistri M. ², Manetti R. ², Farsi M. ² ✉

¹ Surgical and Anesthesiologist Science Course, Careggi Academic and Regional Hospital, Florence, Italy; ² Division of Surgical Oncology, Department of Oncology, Careggi Academic and Regional Hospital, Florence, Italy

AIM: The aim of this paper was to determine if an aggressive surgical approach, with an increase in R0 resections, has resulted in improved survival for patients with gallbladder cancer. Gallbladder cancer is a silent disease, despite the efforts, the prognosis remains dismal. Consensus among surgeons regarding the indications for the extent of resection, lymph node dissection, port site resection, bile duct management has not been reached.
METHODS: A retrospective review of all patients with gallbladder cancer admitted during 12 years period was conducted. Sixteen patients were identified. Cases were divided into 2 cohorts surgical treated group (STG, N.=10) and non surgical treated group (NSTG, N.=6).
RESULTS: In NSTG the disease was metastatic (stage IV): liver (33.3%), peritoneum (50%), liver and peritoneum (16.7%). In STG 13 procedures were performed, 6 liver resection (2 en bloc resection, 2 bisegmentectomy, 2 wedge resection) 7 cholecystectomies. 6 R1, 7 R0 resections. All the liver resections were R0. 0% mortality, 30.7% of morbidity, all the complications were managed conservatively. Length of stay was 10 days for the STG, and 5 days for the NSTG. The median overall survival was 10 months (Std Error 2.381 CI 5.333-14.667), while in the STG 16 months (Std Error 6.275 CI 3.701-28.299) and in the NSTG was 7 months (Std Error 2.381 CI 5.337-14.667)
CONCLUSION: Whenever is possible radical resection with free margin (R0) must be achieved, being the only chance to treat efficiently.