Han Ho-Seong, Yoon Yoo-Seok, Agarwal Anil K, Belli Giulio, Itano Osamu, Gumbs Andrew A, Yoon Dong Sup, Kang Chang Moo, Lee Seung Eun, Wakai Toshifumi, Troisi Roberto I
Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
Seoul National University Bundang Hospital, Seongnam, Republic of
Dig Surg. 2019;36(1):1-6. doi: 10.1159/000486207. Epub 2018 Jan 16.
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.
The study aimed to develop a consensus statement on the application of laparoscopic surgery for GBC based on expert opinions.
A consensus meeting among experts was held on September 10, 2016, in Seoul, Korea.
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.
Laparoscopic surgery for GBC is still in the early phase of the adoption curve, and more evidence is required to assess this procedure.
尽管关于胆囊癌（GBC）腹腔镜手术良好预后的报道越来越多，但对于该手术方法尚无共识。
本研究旨在基于专家意见就GBC腹腔镜手术的应用制定一份共识声明。
2016年9月10日在韩国首尔举行了专家共识会议。
术前对GBC的认识提高以及避免胆汁溢出的谨慎操作，减轻了早期对腹腔镜手术后端口部位/腹膜转移的担忧。如果在腹腔镜胆囊切除术期间/之后进行确定性切除，对于早期GBC患者，没有证据表明腹腔镜手术与开放手术相比会降低生存率。尽管GBC腹腔镜扩大胆囊切除术的经验仅限于少数专家，但腹腔镜手术和开放手术的术后及生存结果相似。术后诊断为GBC的腹腔镜再次手术在技术上具有挑战性，但少数专家已证明其可行性。
GBC腹腔镜手术仍处于采用曲线的早期阶段，需要更多证据来评估该手术。
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