Keywords
Central hepatectomy; Portal lymphadenectomy; Robotic surgery; Cholecystectomy; Hepatobiliary surgery
Abstract
Background: Minimally Invasive Surgery (MIS) is gaining traction within surgical oncology. We aim to evaluate outcomes of patients with gallbladder cancer undergoing MIS surgery compared to open surgery.
Methods: Using the institutional cancer registry and administrative databases, we retrospectively reviewed patients who underwent a central hepatectomy with portal lymphadenectomy for gallbladder cancer from 2011-2014. We excluded gallbladder cancer patients without oncologic resection and those with metastatic disease.
Results: Thirty-four patients underwent surgery: 17 MIS (14 robotic; 3 laparoscopic) and 17 open. There was no statistically significant difference in median operative time (MIS=182 vs open=190 min; p=0.23) or R0 resection (MIS=88.2% vs open=88.2%; p=1.0); however, the MIS cohort had less intraoperative blood loss (median 50 ml vs 400 ml; p=0.006) and placement of peri-hepatic drains (29.4% vs 76.5%; p=0.01) compared to open.MIS cohort went to oral pain medications quicker (2 vs 3 days; p=0.02) and discharged home earlier (4 vs 6 days; p=0.018), than the open cohort. No differences in postoperative 30-day complication rates (52.9% vs 52.9%; p=1.0).
Conclusion: The minimally invasive approach to liver surgery is a safe and equally effective technique for the management of the gallbladder cancer with improvement in blood loss and length of stay.
Citation
Georgakis GV, Novak S, Bartlett DL, Zureikat AH, Zeh HJ and Hogg ME. Revision Posterior Cruciate Ligament Reconstruction or Repair: A Systematic Review. SM Min Inv Surg. 2017; 1(2): 1007.