Surgical Results for Open, Laparoscopic, and Robotic Resections for Gallbladder Cancer

Controversy exists regarding the safety and short-term and long-term oncologic outcomes of minimally invasive versus open surgery for gallbladder cancer (GBC). Data from more recent studies indicate that between the group submitted to minimally invasive radical cholecystectomy and open radical cholecystectomy, there were no significant changes in operating time, neoplastic recurrence, the intra-surgical violation of the gallbladder, the number of patients who received adjuvant chemotherapy, blood transfusion, 30-day mortality, 90-day mortality (with a meta-analysis showing lower 90-day mortality for the minimally invasive group), disease-free survival, and overall survival. They also demonstrate that for the minimally invasive surgery group, there was a lower volume of intraoperative blood loss, a higher incidence of R0 resections, a shorter time to remove the abdominal drain, and a shorter time to reintroduce the diet. However, there are controversial data regarding the survival of the T3 subgroup, the number of resected lymph nodes, and the incidence of recurrence at the port site for the minimally invasive surgery group. In conclusion, a minimally invasive approach to treating GBC is not oncologically inferior to the open approach and has an improved rate of postoperative complications.