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Invited Critique
February 2010

Planned Laparoscopic Approach for Early-Stage Gallbladder Cancer: The Glass Is One-Third Full: Comment on

Author Affiliations

Copyright 2010 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2010

Arch Surg. 2010;145(2):133. doi:10.1001/archsurg.2009.262

Preoperative suspicion of cancer is generally considered a contraindication to LC. However, many patients are found to have benign or pT1a disease, for which LC alone is sufficient. For pT1b or pT2 disease, where nodal metastases are more likely, LC alone is inadequate and portal lymphadenectomy is recommended for staging and tumor clearance. While the role of extended resection of the gallbladder bed for pT1b or pT2 disease can be debated, it is possible that accurate preoperative staging could allow definition of a subset of patients with suspected early-stage GBC in whom a planned initial laparoscopic approach might be reasonable.