Robotic Cholecystectomy in a case of suspicious gallbladder cancer
February 18, 2014
A. Parisi
Gallbladder cancer is a rare malignancy, associated with a poor prognosis because patients often present with advanced stage at the diagnosis. In patients with resectable disease, extensive liver resection, portal lymphadenectomy and bile duct resection may be required, but is associated with high morbidity. In many cases gallbladder cancers are discovered incidentally after cholecystectomy. In particular, according to the American Joint Committee on Cancer (AJCC) staging system, simple cholecystectomy alone is considered definitive treatment in case of T in situ or T1a. However, surgical management remains still controversial especially in a case of radiological suspicion of gallbladder cancer. The video shows a case of patient with suspected gallbladder cancer as a result of radiological examinations. After multidisciplinary evaluation, it was decided to perform an exploratory laparoscopy with intraoperative ultrasound and robotic cholecystectomy combined with liver resection. During the procedure, in contradiction to the preoperative findings, since there was no signs of neoplastic infiltration of the liver parenchyma, after cholecystectomy was agreed to wait a definitive histological examination of the specimen for diagnostic certainty and if necessary, run in a second stage an hepatic radical resection.
