Cassese Gianluca, Han Ho-Seong, Yoon Yoo-Seok, Lee Jun Suh, Cho Jai Young, Lee Hae-Won, Lee Boram, Troisi Roberto Ivan
Department of Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Korea.
Department of Clinical Medicine and Surgery, Division of Minimally Invasive and Robotic HPB Surgery, Federico II University Hospital, 80131 Naples, Italy.
Diagnostics (Basel). 2022 Jul 5;12(7):1630. doi: 10.3390/diagnostics12071630.
Gallbladder carcinoma (GBC) is a rare malignancy, with an estimated 5-year survival rate of less than 5% in the case of advanced disease. Surgery is the only radical treatment for early stages, but its application and effectiveness depend on the depth of tumoral invasion. The extent of resection is usually determined according to the T-stage. Therefore, an early and correct preoperative assessment is important for the prognosis, as well as for the selection of the most appropriate surgical procedure, to avoid unnecessary morbid surgeries and to reach the best outcomes. Several modalities can be used to investigate the depth of invasion, from ultrasounds to CT scans and MRI, but an ideal method still does not exist. Thus, different protocols are proposed according to different recommendations and institutions. In this scenario, the indications for laparoscopic and robotic surgery are still debated, as well as the role of new technologies such as next-generation sequencing and liquid biopsies. The aim of this article is to summarize the state of the art current modalities and future perspectives for assessing the depth of invasion in GBC and to clarify their role in perioperative management accordingly.
胆囊癌（GBC）是一种罕见的恶性肿瘤，晚期病例的估计5年生存率低于5%。手术是早期阶段的唯一根治性治疗方法，但其应用和效果取决于肿瘤浸润深度。切除范围通常根据T分期来确定。因此，早期且正确的术前评估对于预后以及选择最合适的手术方式很重要，以避免不必要的致残性手术并达到最佳治疗效果。从超声到CT扫描和MRI，有多种方式可用于研究浸润深度，但理想的方法仍然不存在。因此，根据不同的建议和机构提出了不同的方案。在这种情况下，腹腔镜手术和机器人手术的适应症以及下一代测序和液体活检等新技术的作用仍存在争议。本文旨在总结评估GBC浸润深度的当前技术水平、现有方式以及未来前景，并相应阐明它们在围手术期管理中的作用。
