P J Shukla1, G Barreto, A Kakade, S V Shrikhande. 1. Department of Gastrointestinal Surgical Oncology, Tata Memorial Hospital, Parel, Mumbai, India. pjshukla@doctors.org.uk
Abstract
BACKGROUND AND AIM: There is a need to increase the available data on revision radical surgery for incidental gallbladder cancer and to determine factors influencing operability. We aimed to assess the impact of stage of disease (pT) and the type of primary surgery (laparoscopy versus open) on resectability rates. MATERIAL AND METHODS: The data of 90 consecutive patients referred to the Tata Memorial Hospital between 1 January 2003 and 30 April 2007 for revision radical surgery for incidental gallbladder cancer were reviewed retrospectively. RESULTS: Of the 90 patients who underwent revision surgery, accurate data on T-stage was available in 76, and of these 76 patients, 44 (57.8%) had prior laparoscopic simple cholecystectomy, while 32 (42.2%) had undergone open surgery. The median time interval between the two surgeries was 2 months (range 4 weeks to 11 months). By T-stage, 23 patients had T1b disease, while 33 and 20 patients had T2 and T3 disease, respectively. Successful revision surgery could be undertaken in 71% of patients (54/76) and 29.6% of these had residual disease confirmed by histopathological examination. CONCLUSIONS: T-stage is an important factor in determining operability as confirmed by our study. As the T-stage of the disease increased, the chances of finding residual disease increased, while operability decreased. Furthermore, the case for revision surgery is strengthened because the incidence of lymph nodal disease is high even for pT1b cancers. The type of primary surgery does not affect operability in patients undergoing revision radical surgery for incidental gallbladder cancer.
BACKGROUND AND AIM: There is a need to increase the available data on revision radical surgery for incidental gallbladder cancer and to determine factors influencing operability. We aimed to assess the impact of stage of disease (pT) and the type of primary surgery (laparoscopy versus open) on resectability rates. MATERIAL AND METHODS: The data of 90 consecutive patients referred to the Tata Memorial Hospital between 1 January 2003 and 30 April 2007 for revision radical surgery for incidental gallbladder cancer were reviewed retrospectively. RESULTS: Of the 90 patients who underwent revision surgery, accurate data on T-stage was available in 76, and of these 76 patients, 44 (57.8%) had prior laparoscopic simple cholecystectomy, while 32 (42.2%) had undergone open surgery. The median time interval between the two surgeries was 2 months (range 4 weeks to 11 months). By T-stage, 23 patients had T1b disease, while 33 and 20 patients had T2 and T3 disease, respectively. Successful revision surgery could be undertaken in 71% of patients (54/76) and 29.6% of these had residual disease confirmed by histopathological examination. CONCLUSIONS: T-stage is an important factor in determining operability as confirmed by our study. As the T-stage of the disease increased, the chances of finding residual disease increased, while operability decreased. Furthermore, the case for revision surgery is strengthened because the incidence of lymph nodal disease is high even for pT1b cancers. The type of primary surgery does not affect operability in patients undergoing revision radical surgery for incidental gallbladder cancer.
Authors: Steve T Weiland; David M Mahvi; John E Niederhuber; Dennis M Heisey; Debra S Chicks; Layton F Rikkers Journal: J Gastrointest Surg Date: 2002 Jan-Feb Impact factor: 3.452
Authors: Jason M Foster; Hisakazu Hoshi; John F Gibbs; Renuka Iyer; Miland Javle; Quyen Chu; Boris Kuvshinoff Journal: Ann Surg Oncol Date: 2006-11-11 Impact factor: 5.344
Authors: K Tsukada; I Kurosaki; K Uchida; Y Shirai; Y Oohashi; N Yokoyama; H Watanabe; K Hatakeyama Journal: Cancer Date: 1997-08-15 Impact factor: 6.860
Authors: Xabier A de Aretxabala; Ivan S Roa; Javier P Mora; Juan J Orellana; Juan P Riedeman; Luis A Burgos; Veronica P Silva; Alvaro J Cuadra; Harold J Wanebo Journal: World J Surg Date: 2004-06 Impact factor: 3.352
Authors: Samuel P Shih; Richard D Schulick; John L Cameron; Keith D Lillemoe; Henry A Pitt; Michael A Choti; Kurtis A Campbell; Charles J Yeo; Mark A Talamini Journal: Ann Surg Date: 2007-06 Impact factor: 12.969
Authors: T Tsirlis; F Ausania; S A White; J J French; B C Jaques; R M Charnley; D M Manas Journal: Ann R Coll Surg Engl Date: 2015-03 Impact factor: 1.891
Authors: Kui Sun Choi; Sae Byeol Choi; Pyoungjae Park; Wan Bae Kim; Sang Yong Choi Journal: World J Gastroenterol Date: 2015-01-28 Impact factor: 5.742
Authors: Jean M Butte; Mithat Gönen; Peter J Allen; Michael I D'Angelica; T Peter Kingham; Yuman Fong; Ronald P Dematteo; Leslie Blumgart; William R Jarnagin Journal: HPB (Oxford) Date: 2011-06-07 Impact factor: 3.647
Authors: Fabio Ausania; Theodoris Tsirlis; Steven A White; Jeremy J French; Bryon C Jaques; Richard M Charnley; Derek M Manas Journal: HPB (Oxford) Date: 2013-01-07 Impact factor: 3.647