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Safety and feasibility of pure laparoscopic extended cholecystectomy: comparison with the open technique in a propensity analysis at a single center

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Abstract

Background

The aim of this study was to validate the safety and feasibility of pure laparoscopic extended cholecystectomy (LEC) by comparing the outcome with that of open extended cholecystectomy (OEC). Moreover, on the basis of our experience, we also aimed to investigate the learning curve of pure LEC.

Methods

This single-center study enrolled patients who were diagnosed primary gallbladder cancer with pathologically confirmed and underwent R0 resection with curative intent between January 2016 and December 2019. A total of 31 patients who underwent OEC and 17 patients who underwent LEC were selected. Propensity score matching analysis was performed in a 1:1 ratio using the nearest-neighbor matching method, and clinical information was retrospectively collected from medical records and analyzed.

Results

The postoperative hospital stay was statistically shorter in the LEC group (7 days) than in the OEC group (12 days). The overall surgical complication rate did not differ between the two groups. The 1- and 3-year disease-free survival rates were 82.4% and 82.4% in the OEC group and 94.2% and 71.5% in the LEC group, respectively (P = 0.94). Considering the correlation between the number of cumulative cases and the operation time and between the number of cumulative cases and the number of retrieved lymph nodes in the LEC group, as the cases were accumulated, both the operation time and the number of retrieved lymph nodes had a statistically significant correlation with the number of cases.

Conclusions

LEC showed a significant advantage in terms of achieving shorter postoperative hospital stay and similar results to OEC with respect to overall complications and pathological outcomes. The present results confirm that laparoscopy can be considered a safe treatment for primary gallbladder cancer in selected patients.

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Acknowledgements

We would like to give special thanks to Mr. Dan-te An at Korea University Guro Hospital for his help in figure making.

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Authors and Affiliations

  1. Division of Hepatobiliary Pancreatic Surgery, Department of Surgery, Korea University Guro Hospital, Korea University Medical College, Seoul, Korea

    Wan-Joon Kim, Sae-Byeol Choi & Wan-Bae Kim

  2. Division of Transplantation Vascular Surgery, Department of Surgery, Korea University Guro Hospital, Korea University Medical College, Seoul, Korea

    Tae-Wan Lim & Pyoung-Jae Park

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  1. Wan-Joon Kim
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  2. Tae-Wan Lim
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  4. Sae-Byeol Choi
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Correspondence to Wan-Bae Kim.

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Wan-Joon Kim, Tae-Wan Lim, Pyoung-Jae Park, Sae-Byeol Choi, and Wan-Bae Kim have no conflicts of interest or financial ties to disclose.

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Kim, WJ., Lim, TW., Park, PJ. et al. Safety and feasibility of pure laparoscopic extended cholecystectomy: comparison with the open technique in a propensity analysis at a single center. Surg Endosc 35, 6166–6172 (2021). https://doi.org/10.1007/s00464-020-08112-3

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  • DOI: https://doi.org/10.1007/s00464-020-08112-3

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