Bi-segmentectomy versus wedge hepatic resection in extended cholecystectomy for T2 and T3 gallbladder cancer: A matched case-control study

Hirdaya Hulas Nag; Phani Kumar Nekarakanti; Ashish Sachan; Prithviraj Nabi; Sonam Tyagi

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저자정보: Hirdaya Hulas Nag (Govind Ballabh Pant Institute of Postgraduate Medical Education and Research) Phani Kumar Nekarakanti (Govind Ballabh Pant Institute of Postgraduate Medical Education and Research) Ashish Sachan (Govind Ballabh Pant Institute of Postgraduate Medical Education and Research) Prithviraj Nabi (Govind Ballabh Pant Institute of Postgraduate Medical Education and Research) Sonam Tyagi (Govind Ballabh Pant Institute of Postgraduate Medical Education and Research)

저널정보: 한국간담췌외과학회 Annals of Hepato-Biliary-Pancreatic Surgery 한국간담췌외과학회지 제25권 제4호

발행연도: 2021.11

수록면: 485 - 491 (7page)

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Backgrounds/Aims: Extended cholecystectomy (EC) is the mainstay of treatment in most patients with potentially curable gallbladder cancer (GBC). The optimum extent of hepatic resection in EC is debatable.
Methods: This retrospective study was conducted on patients with GBC who received EC from May 2009 to February 2019. Based on the extent of hepatic resection, patients were divided into ECB (EC involving bi-segmentectomy s4b&5) and ECW (EC involving wedge hepatic resection) groups. Patients with T1 GBC, T4 GBC, and benign diseases were excluded. Post-exclusion, both groups were matched for T and N stage. Matched groups were then compared.
Results: Out of a total of 161 patients who received EC, 86 patients had ECB and 75 patients had ECW. After exclusion and matching, both ECB and ECW groups had 35 patients. Their demographic and clinical profiles were comparable. Surgical blood loss (p = 0.005) and postoperative complication rate (p = 0.035) were significantly less in the ECB group. For ECB vs. ECW, mean recurrence-free survival (RFS) was 58.2 months vs. 42.3 months (p = 0.264) and overall survival (OS) was 61.5 months vs. 43.4 months (p = 0.161). On univariate analysis, higher T and N stages were associated with poor prognosis. On multivariate analysis, higher T stage, N stage, and American Society of Anaesthesiologists grade were associated with poor RFS and OS.
Conclusions: The survival after ECB for T2 and T3 GBC was not significantly superior to that after ECW. However, surgical blood loss and postoperative complications were lower following ECB.

#Gallbladder neoplasms #Extended cholecystectomy #Radical cholecystectomy #Bi-segmentectomy #Wedge hepatic resection

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