Abstract | BACKGROUND: METHODS: A 50-year-old woman underwent laparoscopic cholecystectomy, and pathology revealed a T1b gallbladder carcinoma. The patient was referred for further treatment. Contact with the primary surgeon revealed that no intraoperative cholangiogram was performed, and the gallbladder was removed intact, with no perforation, and inside a plastic retrieval bag. Pathology revision confirmed T1b, and positron emission tomography/computed tomography was negative. The multidisciplinary tumor board recommended radical re-resection, and a decision was made to perform a laparoscopic extended hilar lymphadenectomy, along the resection of segments 5 and 4b. RESULTS:
Operative time was 5 h, with an estimated blood loss of 240 mL. Recovery was uneventful and the patient was discharged on the fourth postoperative day. Final pathology showed no residual disease and no lymph node metastasis. CONCLUSIONS: Laparoscopic resection of liver segments 5 and 4b combined with a locoregional lymphadenectomy of the hepatoduodenal ligament is an oncologically appropriate technique, provided it is performed in a specialized center with experience in hepatobiliary surgery and advanced laparoscopic surgery. This video may help oncological surgeons to perform this complex procedure.
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Authors | Marcel Autran Machado, Fabio F Makdissi, Rodrigo C Surjan |
Journal | Annals of surgical oncology
(Ann Surg Oncol)
Vol. 22 Suppl 3
Pg. S336-9
(Dec 2015)
ISSN: 1534-4681 [Electronic] United States |
PMID | 26059653
(Publication Type: Case Reports, Journal Article)
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Topics |
- Cholecystectomy, Laparoscopic
(methods)
- Female
- Gallbladder Neoplasms
(surgery)
- Hepatectomy
(methods)
- Humans
- Incidental Findings
- Lymph Node Excision
(methods)
- Middle Aged
- Prognosis
- Video Recording
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