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Role of common bile duct resection in T2 and T3 gallbladder cancer patients
Ann Hepatobiliary Pancreat Surg 2018 Feb;22(1):42-51
Published online February 28, 2018
Copyright © 2018 Ann Hepatobiliary Pancreat Surg.

Jin Hong Lim1, Jae Uk Chong2, Sung Hoon Kim3, Seung Woo Park4, Jin Sub Choi2, Woo Jung Lee2, and Kyung Sik Kim2

1Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul,2Department of Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul,3Department of Surgery, Wonju Severance Christian Hospital, Yonsei University College of Medicine, Wonju, 4Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
Received March 4, 2017; Revised September 7, 2017; Accepted September 17, 2017.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract
Backgrounds/Aims: Routine bile duct resection as part of the typical oncological resection for patients with advanced gallbladder cancer remains controversial with regard to, ultimately, curative value. The aim of this study was to compare oncological outcomes for patients undergoing surgery for gallbladder cancer with or without bile duct resection. Methods: We recruited, for the purpose of this study, all patients who underwent surgical resection for T2 and T3 gallbladder cancer at Severance hospital, Seoul, Korea, during the period January 2000 and December of 2011. The patient data was reviewed retrospectively. Results: The patients (n=149) recruited to participate in the study were divided into two groups according to their bile duct resection status: The bile duct resection group (BDR group, n=54); and, the bile duct non-resection group (BDNR group, n=95). Significant difference was found in lymph node retrieval between BDR and BDNR groups (15 vs. 5, respectively with p<0.001). There was no significant difference between the two groups with regard to the five year survival rate (43% in BDR group vs. 57% in BDNR group, p=0.339). Following multivariate analysis, lymph node metastasis, advanced T-stage, and total retrieved lymph nodes <6 were independent prognostic factors for poor survival in patients with T2 and T3 gallbladder cancer. Conclusions: The findings revealed by the current study suggest that the role of bile duct resection might be limited to improved staging, and offers no advantage in long-term survival. However, in view of the foregoing and given the minimal increase in morbidity associated with BDR, it should be actively considered as a treatment option for patients who present with findings suspicious for invasion around hepatoduodenal ligament. (Ann Hepatobiliary Pancreat Surg 2018;22:42-51)
Keywords : Gallbladder neoplasms; Common bile duct; Survival rate; Prognosis