title: Current Role of Minimally Invasive Radical Cholecystectomy for Gallbladder Cancer.
abstract: Background. For Tis and T1a gallbladder cancer (GbC), laparoscopic cholecystectomy can provide similar survival outcomes compared to open cholecystectomy. However, for patients affected by resectable T1b or more advanced GbC, open approach radical cholecystectomy (RC), consisting in gallbladder liver bed resection or segment 4b-5 bisegmentectomy, with locoregional lymphadenectomy, is considered the gold standard while minimally invasive RC (MiRC) is skeptically considered.Aim. To analyze current literature on perioperative and oncologic outcomes of MiRC for patients affected by GbC.Methods. A Medline review of published articles until June 2016 concerning MiRC for GbC was performed.Results. Data relevant for this review were presented in 13 articles, including 152 patients undergoing an attempt of MiRC for GbC. No randomized clinical trial was found. The approach was laparoscopic in 147 patients and robotic in five. Conversion was required in 15 (10%) patients. Postoperative complications rate was 10% with no mortality. Long-term survival outcomes were reported by 11 studies, two of them showing similar oncologic results when comparing MiRC with matched open RC.Conclusions. Although randomized clinical trials are still lacking and only descriptive studies reporting on limited number of patients are available, current literature seems suggesting that when performed at highly specialized centers, MiRC for GbC is safe and feasible and has oncologic outcomes comparable to open RC.
authors.affiliation: Department of General Surgery, Istituto Ospedaliero Fondazione Poliambulanza, Via Bissolati n 57, Brescia, Italy.
authors.forename: Giuseppe
authors.identifier: 0000-0003-4925-4012
authors.initials: G
authors.lastname: Zimmitti
authors.affiliation: Department of General Surgery, Istituto Ospedaliero Fondazione Poliambulanza, Via Bissolati n 57, Brescia, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Manzoni
authors.affiliation: Department of General Surgery, Istituto Ospedaliero Fondazione Poliambulanza, Via Bissolati n 57, Brescia, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Guerini
authors.affiliation: Department of General Surgery, Istituto Ospedaliero Fondazione Poliambulanza, Via Bissolati n 57, Brescia, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Ramera
authors.affiliation: Department of Oncology, Istituto Ospedaliero Fondazione Poliambulanza, Via Bissolati n 57, Brescia, Italy.
authors.forename: Paola
authors.identifier: 0000-0002-6616-2518
authors.initials: P
authors.lastname: Bertocchi
authors.affiliation: Department of Oncology, Istituto Ospedaliero Fondazione Poliambulanza, Via Bissolati n 57, Brescia, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Aroldi
authors.affiliation: Department of Oncology, Istituto Ospedaliero Fondazione Poliambulanza, Via Bissolati n 57, Brescia, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Zaniboni
authors.affiliation: Department of General Surgery, Istituto Ospedaliero Fondazione Poliambulanza, Via Bissolati n 57, Brescia, Italy.
authors.forename: Edoardo
authors.initials: E
authors.lastname: Rosso