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  • Current status and future p...
    Liu, Fei; Wu, Zhen‐Ru; Hu, Hai‐Jie; Jin, Yan‐Wen; Ma, Wen‐Jie; Wang, Jun‐Ke; Li, Fu‐Yu

    ANZ journal of surgery, March 2021, 2021-03-00, 20210301, Letnik: 91, Številka: 3
    Journal Article

    Background Gallbladder carcinoma (GBC) is the most common biliary tract malignancy, which is characterized by easy local invasion, lymph nodes metastasis, local vascular invasion. Hence, minimally invasive surgery (MIS) can be performed in a limited number of patients. In our study, we reviewed the current studies on laparoscopic surgery (LS) and robotic surgery (RS) for GBC and analysed the limitations and difficulties of MIS for GBC. Methods Multiple electronic databases were used for a systematic literature retrieval. All studies involving MIS of GBC were included (up to August 2019). Results A total of 24 studies were included, of which 18 studies involved LS for GBC and six studies concerned RS of GBC. For LS, 16 studies contained relevant information of T stage, and 323 patients (98.8%) had T3 or lower stage; the average rate of R0 resection, conversion, postoperative complications and mortality was 95.3% (range 80.5–100%), 1.9% (range 0–16.7%), 13.4% (range 0–33.3%) and 1.0% (range 0–10%), respectively. For RS, four studies contained relevant information of T stage, and all patients were T3 or lower stage; the average rate of R0 resection, conversion and postoperative complications was 96.8% (range 81.8–100%), 5.5% (range 0–14.8%) and11.9% (range 0–36.4%), respectively. In addition, no patient had perioperative mortality. Conclusions MIS for GBC is limited to highly selected patients and is considered to be technically feasible in experienced surgeons. However, improvements in technical and instrumental are needed to reduce the associated postoperative complications and implantation metastasis, and to promote MIS in the treatment of GBC. In our study, we reviewed 24 studies on laparoscopic surgery and robotic surgery for gallbladder carcinoma (GBC) and analysis the limitations and difficulties of minimally invasive surgery (MIS) for GBC. MIS for GBC is limited to highly screened patients and is considered to be technically feasible in experienced surgeons. However, improvements in technical and instrumental are needed to reduce the associated postoperative complications and implantation metastasis, and to promote MIS in the treatment of GBC.