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ORIGINAL RESEARCH article

Front. Surg.
Sec. Surgical Oncology
Volume 11 - 2024 | doi: 10.3389/fsurg.2024.1418314

Incidental gallbladder cancer detected during laparoscopic cholecystectomy: Conversion to extensive resection is a feasible choice.

Provisionally accepted
Di Zeng Di Zeng Yaoqun Wang Yaoqun Wang Ningyuan Wen Ningyuan Wen Jiong Lu Jiong Lu NANSHENG CHENG NANSHENG CHENG *Bei Li Bei Li *
  • West China Hospital, Sichuan University, Chengdu, China

The final, formatted version of the article will be published soon.

    Background: Extensive resection is recommended for patients with incidental gallbladder carcinoma (iGBC) at T1b stage and above. It is unclear whether continuation of laparoscopic extensive-resection (CLR) for patients with intraoperatively detected iGBC (ID-iGBC) is more beneficial to short- and long-term clinical outcomes than with conversion to laparotomy extensive-resection (COR). Methods: This single-centre, retrospective cohort study of patients with iGBC was conducted between June 2006 and August 2021. Patients who underwent immediate extensive-resection for T1b or higher ID-iGBC were enrolled. Propensity score matching (PSM) was used to match the two groups (CLR and COR) of patients, and differences in clinical outcomes before and after matching were analyzed. Result: A total of 102 patients with ID-iGBC were included in this study. 58 patients underwent CLR, and 44 underwent COR. After 1:1 propensity score matching, 56 patients were matched to all baselines. Patients in the COR group had a lower total postoperative complication rate, lower pulmonary infection rate, and shorter operation time than those in the CLR group did. Kaplan-Meier analysis showed that the overall survival rate of patients who underwent CLR was significantly lower than that of patients who underwent COR. Multivariate analysis showed that CLR, advanced T stage, lymph node positivity, and the occurrence of postoperative ascites were adverse prognostic factors for the overall survival of patients. Conclusion: Patients with ID-iGBC who in the COR group had fewer perioperative complications and a better prognosis than the CLR group. For patients with ID-iGBC, conversion to laparotomy extensive-resection appears to be a better choice.

    Keywords: Incidental gallbladder carcinoma, Hepatectomy, Laparotomy, prognosis, Propensity score analysis Aspartate Aminotransferase. CLR:Continuation of laparoscopic extensive-resection, COR:Conversion to laparotomy extensive-resection, GBC: Gallbladder carcinoma. Hb: Hemoglobin. ID-iGBC: Intraoperatively detected iGBC, iGBC: Incidental gallbladder carcinoma. OS: Overall Survival. PLT: Platelets. PSM: Propensity score matching. TB: Total Bilirubin. WBC: Leukocyte

    Received: 16 Apr 2024; Accepted: 25 Jul 2024.

    Copyright: © 2024 Zeng, Wang, Wen, Lu, CHENG and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    NANSHENG CHENG, West China Hospital, Sichuan University, Chengdu, China
    Bei Li, West China Hospital, Sichuan University, Chengdu, China

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