Laparoscopic cholecystectomy and gallbladder cancer
| Autor: | M. A. Reymond, Hans Lippert, Emil Sagynaliev, Ralf Steinert, Jörg Müller, G. Nestler |
|---|---|
| Rok vydání: | 2006 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Catheters Indwelling Polyps medicine Hepatectomy Humans Cholecystectomy Gallbladder cancer Radical surgery Laparoscopic cholecystectomy Retrospective Studies business.industry Incidence Gallbladder General surgery Retrospective cohort study General Medicine Middle Aged Prognosis medicine.disease Surgery Treatment Outcome medicine.anatomical_structure Cholecystectomy Laparoscopic Oncology Second-Look Surgery Lymph Node Excision Gallbladder Neoplasms Lymphadenectomy Neoplasm Recurrence Local business |
| Zdroj: | Journal of Surgical Oncology. 93:682-689 |
| ISSN: | 1096-9098 0022-4790 |
| DOI: | 10.1002/jso.20536 |
| Popis: | Heightened awareness of the possible presence of gallbladder cancer (GBC) and the knowledge of appropriate management are important for surgeons practising laparoscopic cholecystectomy (LC). Long-term effects of initial LC versus open cholecystectomy (OC) on the prognosis of patients with GBC remain undefined. Patients who are suspected to have GBC should not undergo LC, since it is advantageous to perform the en-bloc radical surgery at the initial operation. Since preoperative diagnosis of early GBC is difficult, preventive measures, such as preventing bile spillage and bagging the gallbladder should be applied for every LC. Many port-site recurrences (PSR) have been reported after LC, but the incidence of wound recurrence is not higher than after OC. No radical procedure is required after postoperative diagnosis of incidental pT1a GBC. It is unclear if patients with pT1b GBC require extended cholecystectomy. In pT2 GBC, patients should have radical surgery (atypical or segmental liver resection and lymphadenectomy). In advanced GBC (pT3 and pT4), radical surgery can cure only a small subset of patients, if any. Additional port-site excision is recommended, but the effectiveness of such measure is debated. |
| Databáze: | OpenAIRE |
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