Laparoscopic Surgery for Gallbladder Cancer: An Expert Consensus Statement
Laparoscopic Surgery for Gallbladder Cancer: An Expert Consensus Statement
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DOI：
10.1159/000486207
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发表时间：
2019-01-01
影响因子：
2.7
通讯作者：
Troisi, Roberto I.
中科院分区：
文献类型：
--
作者：
Han, Ho-Seong;Yoon, Yoo-Seok;Troisi, Roberto I.
背景资料：尽管腹腔镜手术治疗胆囊癌（GBC）的有利结果的报道越来越多，但关于这种手术方法还没有达成共识。目的：本研究旨在根据专家意见制定关于腹腔镜手术治疗胆囊癌的共识声明。方法：2016年9月10日在韩国首尔举行专家共识会议。结果如下：通过提高术前对胆囊癌的认识和小心操作以避免胆汁溢出，已经减轻了腹腔镜手术后关于端口部位/腹膜转移的早期担忧。没有证据表明，如果在腹腔镜胆囊切除术期间/之后进行确定性切除，与开放手术相比，腹腔镜手术与早期GBC患者的生存率降低相关。虽然腹腔镜胆囊癌扩大胆囊切除术的经验仅限于少数专家，腹腔镜手术和开放手术的术后和生存结局相似。腹腔镜下再次手术治疗术后诊断的胆囊癌在技术上具有挑战性，但其可行性已被少数专家证明。结论：腹腔镜手术治疗胆囊癌仍处于采用曲线的早期阶段，需要更多的证据来评估这种手术。(C)2018 S. Karger AG，巴塞尔
Background: Despite the increasing number of reports on the favorable outcomes of laparoscopic surgery for gallbladder cancer (GBC), there is no consensus regarding this surgical procedure. Objective: The study aimed to develop a consensus statement on the application of laparoscopic surgery for GBC based on expert opinions. Methods: A consensus meeting among experts was held on September 10, 2016, in Seoul, Korea. Results: Early concerns regarding port site/peritoneal metastasis after laparoscopic surgery have been abated by improved preoperative recognition of GBC and careful manipulation to avoid bile spillage. There is no evidence that laparoscopic surgery is associated with decreased survival compared with open surgery in patients with early-stage GBC if definitive resection during/after laparoscopic cholecystectomy is performed. Although experience with laparoscopic extended cholecystectomy for GBC has been limited to a few experts, the postoperative and survival outcomes were similar between laparoscopic and open surgeries. Laparoscopic reoperation for postoperatively diagnosed GBC is technically challenging, but its feasibility has been demonstrated by a few experts. Conclusions: Laparoscopic surgery for GBC is still in the early phase of the adoption curve, and more evidence is required to assess this procedure. (C) 2018 S. Karger AG, Basel