Current status and progress in laparoscopic surgery for gallbladder carcinoma

Table 1 Summary of gallbladder carcinoma T staging according to the American Joint Committee on Cancer 8^th edition and the corresponding surgical approach

	AJCC 8th T staging classification	Surgical approach
Tis	Carcinoma in situ	Simple cholecystectomy
T1a	Tumor invades the lamina propria	Simple cholecystectomy
T1b	Tumor invades the muscular layer	Extended cholecystectomy including cholecystectomy + lymphadenectomy ± hepatectomy (current consensus)/simple cholecystectomy (under debate)
T2a	Tumor invades the perimuscular connective tissue on the peritoneal side, without involvement of the serosa	Extended cholecystectomy including cholecystectomy + lymphadenectomy ± hepatectomy ± bile duct resection and reconstruction
T2b	Tumor invades the perimuscular connective tissue on the hepatic side, with no extension into the liver	Extended cholecystectomy including cholecystectomy + lymphadenectomy + hepatectomy ± bile duct resection and reconstruction
T3	Tumor perforates the serosa (visceral peritoneum) and/or directly invades the liver and/or one other adjacent organ or structure, such as the stomach, duodenum, colon, pancreas, omentum or extrahepatic bile ducts	Extended cholecystectomy including cholecystectomy + lymphadenectomy + hepatectomy ± bile duct resection and reconstruction (some T3 without distant metastasis)/hepatopancreatoduodenectomy (under debate)
T4	Tumor invades the main portal vein or hepatic artery or invades two or more extrahepatic organs or structures	No significant benefit from surgery

AJCC: American Joint Committee on Cancer.

Table 2 Summary of the published cases of laparoscopic hepatopancreatoduodenectomy for locally advanced gallbladder carcinoma or extrahepatic cholangiocarcinoma

Ref.	Country	Age (yr)	Diagnosis	Operation	Operation duration (min)	Main complication	Hospital stay (d)
Zhang et al[57], 2014	China	61	ECC invading the duodenum	LPD + LRH	600	Bile leakage	16
Chong and Choi[58], 2019	South Korea	73	ECC	LPD + LLH	510	Cystitis	16
James et al[59], 2021	India	73	GBC infiltrating the CBD	LPD + segments IVb and V	610	Delayed gastric emptying	12
Yao[56], 2022	China	75	ECC + GBC	LPD + segments IVb and V	380	No	12

ECC: Extrahepatic cholangiocarcinoma; GBC: Gallbladder carcinoma; CBD: Common bile duct; LPD: Laparoscopic pancreatoduodenectomy; LRH: Laparoscopic right hemihepatectomy; LLH: Laparoscopic left hemihepatectomy.