title: Higher complication rate in hepatocellular carcinoma patients undergoing prophylactic cholecystectomy with curative hepatic resection.
abstract: OBJECTIVE
  We performed a retrospective analysis to evaluate the short and long-term impact of simultaneous prophylactic cholecystectomy with hepatectomy in these patients.
  
  
  METHODS
  We identified 642 patients who underwent curative hepatocellular carcinoma resection between 2001 and 2005 at five university hospitals. One hundred and twenty-five hepatocellular carcinoma patients who received left lateral sectionectomy or partial resection in the left lateral and Spiegel lobes were identified and followed. They were divided into two groups, 74 with and 51 without simultaneous cholecystectomy. None of these patients had gallbladder stones or polyps at preoperative diagnosis.
  
  
  RESULTS
  Although not statistically significant, the operating time was longer and blood loss was greater in the cholecystectomy group. Patients in the cholecystectomy group had a significantly higher postoperative morbidity rate. Surgical complications according to the Clavien classification differed significantly between the two groups. Variables significantly associated with complications in the univariate and multivariate analyses were simultaneous cholecystectomy and operative blood loss ≥ 1000 ml.
  
  
  CONCLUSIONS
  Simultaneous cholecystectomy of the asymptomatic gallbladder with curative resection of hepatocellular carcinoma in the left lateral section or Spiegel lobe resulted in higher postoperative complications. Consequently, the gallbladder should be preserved except in cases of gallbladder stones or polyps.
authors.forename: Masaki
authors.initials: M
authors.lastname: Kaibori
authors.forename: Shoji
authors.initials: S
authors.lastname: Kubo
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nagano
authors.forename: Michihiro
authors.initials: M
authors.lastname: Hayashi
authors.forename: Takuya
authors.initials: T
authors.lastname: Nakai
authors.forename: Morihiko
authors.initials: M
authors.lastname: Ishizaki
authors.forename: Kosuke
authors.initials: K
authors.lastname: Matsui
authors.forename: Takahiro
authors.initials: T
authors.lastname: Uenishi
authors.forename: Shigekazu
authors.initials: S
authors.lastname: Takemuraz
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Wada
authors.forename: Shigeru
authors.initials: S
authors.lastname: Marubashi
authors.forename: Koji
authors.initials: K
authors.lastname: Komeda
authors.forename: Fumitoshi
authors.initials: F
authors.lastname: Hirokawa
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Nakata
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Uchiyama
authors.forename: Masanori
authors.initials: M
authors.lastname: Kwon
mesh_terms: D000368:Aged; D016063:Blood Loss, Surgical; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016009:Chi-Square Distribution; D002763:Cholecystectomy / Q000009:adverse effects* / Q000401:mortality; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects* / Q000401:mortality; D006785:Hospitals, University; D006801:Humans; D007564:Japan; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local; D016017:Odds Ratio; D061646:Operative Time; D011183:Postoperative Complications / Q000209:etiology* / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome