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Incidental gallbladder cancer by the AFC-GBC-2009 Study Group.

Abstract：

BACKGROUND:Incidental gallbladder cancer (GBC) is frequently discovered on the specimen when cholecystectomy for a benign disease is performed. The objective of the present study was to assess the management of incidental GBC patients in a French registry. METHODS:Data on patients with GBC treated between 1998 and 2008 were retrospectively collated in a French, multicenter database. RESULTS:The registry contained 218 patients with incidental GBC (67 men and 151 women; median age = 64 years; age range = 31-88). One hundred forty-eight (68%) patients underwent re-resection after a median time interval of 48 days (range = 2-245). The most common complete procedure (66% of cases) was 4b + 5 segmentectomy with lymphadenectomy but not bile duct resection. Port-site excision was performed in 54 patients. The mortality and morbidity rates were 3 and 37%, respectively. Resection of the common bile duct (43%) increased postoperative complications (60 vs. 23%, p = 0.0001). Local residual tumor was found in 83 (56%) patients; it was significantly correlated with the T stage and influenced long-term survival. R0 was obtained in 143 (97%) patients and port-site invasion was histologically confirmed in one patient (1.8%). After a median follow-up period of 34 months, the 1-, 3-, and 5-year survival rates for the 148 patients with re-resection were 76, 54, and 41%, respectively. Re-resection significantly increased survival in patients with T2 (p = 0.0001) and T3 (p = 0.04) disease. Resection of the common bile duct increased neither R0 resection nor overall survival (p = 0.06). CONCLUSION:This study validates the concept of re-resection in T2 and T3 GBC. Bile duct resection increases postoperative morbidity but does not improve survival. There is currently a modification in the surgical management of incidental GBC, with minor liver resection and no common bile duct resection.

journal_name

World J Surg

journal_title

World journal of surgery

authors

Fuks D,Regimbeau JM,Le Treut YP,Bachellier P,Raventos A,Pruvot FR,Chiche L,Farges O

doi

10.1007/s00268-011-1134-3

subject

Has Abstract

pub_date

2011-08-01 00:00:00

pages

1887-97

issue

eissn

0364-2313

issn

1432-2323

journal_volume

pub_type

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Incidental gallbladder cancer by the AFC-GBC-2009 Study Group.