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Indian Journal of Medical and Paediatric Oncology
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Year : 2005  |  Volume : 26  |  Issue : 4  |  Page : 54-60

Role of Laparoscopy in the management of gallbladder cancer

Department of Surgery, All India Institute of Medical Sciences, New Delhi-110029

Correspondence Address:
SK Garg
Department of Surgery, All India Institute of Medical Sciences, New Delhi-110029

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Source of Support: None, Conflict of Interest: None

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Minimal Access approaches have become established in nearly all fields of surgery, gastroenterology and cardiology because of obvious advantages to the patients. The cardinal benefits include-significantly less post-operative pain, reduced requirement of postoperative analgesia, decreased hospitalization and earlier return to normal activities. Following the development of laparoscopy to treat benign surgical diseases, its role has expanded lately for the surgical management of malignancies. The use of laparoscopy in cancer patients is the subject of increasing excitement and controversy. The issues of safety of laparoscopic procedures in cancer patients have been debated and some settled (port site recurrence). Carcinoma of the gallbladder is a highly fatal disease with a overall 5-year survival rate of 5 percent -10 percent. The mainstay of therapy for gallbladder cancer (GBC) is conventional surgery. Incidental GBC has been reported following laparoscopic/open cholecystectomy for benign gallbladder disease. Laparoscopic cholecystectomy may be therapeutic in patients with incidental gallbladder cancer of early stage (T1a). However gallbladder cancer beyond Stage 1a i.e. Ib, II, III and IV all require completion conventional surgery in the form of liver resection of segment IV and V with portal lymphadenectomy. The role of laparoscopy in the management of GBC is largely diagnostic. The diagnostic laparoscopy is being increasingly used in patients with known or highly suspected GBC to assess the resectability, staging and avoiding unnecessary laparotomy in inoperable cases.

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