Piccolo G, Barabino M, Piozzi GN, Bianchi PP. Radical cholecystectomy without liver resection for peritoneal side early incidental gallbladder cancer. World J Gastroenterol 2024; 30(32): 3739-3742 [DOI: 10.3748/wjg.v30.i32.3739]
Corresponding Author of This Article
Gaetano Piccolo, FACS, MD, PhD, Attending Doctor, Department of Health Sciences (DISS), University of Milan, San Paolo Hospital, Via Antonio di Rudinì 8, Milan 20142, Lombardy, Italy. gpiccolo1983@gmail.com
Research Domain of This Article
Surgery
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Aug 28, 2024; 30(32): 3739-3742 Published online Aug 28, 2024. doi: 10.3748/wjg.v30.i32.3739
Radical cholecystectomy without liver resection for peritoneal side early incidental gallbladder cancer
Gaetano Piccolo, Matteo Barabino, Guglielmo Niccolò Piozzi, Paolo Pietro Bianchi
Gaetano Piccolo, Matteo Barabino, Paolo Pietro Bianchi, Department of Health Sciences (DISS), University of Milan, San Paolo Hospital, Milan 20142, Lombardy, Italy
Guglielmo Niccolò Piozzi, Department of Colorectal Surgery, Portsmouth Hospitals University NHS Trust, Portsmouth, United Kingdom
Author contributions: Piccolo G conducted conceptualization, formal analysis, supervision and investigation; Piccolo G and Piozzi GN conducted writing original draft preparation; Barabino M and Bianchi PP conducted writing, review and editing. The authors read and approved the final manuscript.
Conflict-of-interest statement: The corresponding author declares that the manuscript has been submitted on behalf of all authors. All authors declare that they have no competing interests.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Gaetano Piccolo, FACS, MD, PhD, Attending Doctor, Department of Health Sciences (DISS), University of Milan, San Paolo Hospital, Via Antonio di Rudinì 8, Milan 20142, Lombardy, Italy. gpiccolo1983@gmail.com
Received: March 26, 2024 Revised: August 1, 2024 Accepted: August 6, 2024 Published online: August 28, 2024 Processing time: 153 Days and 13.4 Hours
Abstract
Gallbladder cancer (GBC) is a rare disease with a poor prognosis. Simple cholecystectomy may be an adequate treatment only for very early disease (Tis, T1a), whereas reoperation is recommended for more advanced disease (T1b and T2). Radical cholecystectomy should have two fundamental objectives: To radically resect the liver parenchyma and to achieve adequate clearance of the lymph nodes. However, recent studies have shown that compared with lymph node dissection alone, liver resection does not improve survival outcomes. The oncological roles of lymphadenectomy and liver resection is distinct. Therefore, for patients with incidental GBC without liver invasion, hepatic resection is not always mandatory.
Core Tip: Hepatic resection for incidental gallbladder cancer (IGC) should aim to: Remove the tumor that has directly invaded the liver through the gallbladder bed and prevent micrometastases that may recur around the gallbladder bed. No consensus is available regarding the extension of liver resection according to its tumor location (hepatic or peritoneal side) and whether hepatic resection can prevent liver recurrence. According to the recent studies, radical cholecystectomy without liver resection may be an adequate treatment for patients with peritoneal side T2 IGC.