Gallbladder carcinoma is occasionally identified incidentally on pathology following cholecystectomy. When confirmed at stage T1b with no metastatic spread, a specific surgical strategy is indicated for sufficiently fit patients.
Gallbladder carcinoma incidentally diagnosed after cholecystectomy, stage T1b, with no metastatic spread. Re-operation with radical intent should be offered to sufficiently fit patients in this setting.
Management centres on a re-operative surgical procedure carried out with radical intent, involving hepatic resection and regional lymph node clearance. Depending on operative circumstances, additional resection may also be considered.
R0 resection — complete surgical removal with no tumour at the margin.
DOI: 10.1016/j.annonc.2022.10.506
In case of incidentally diagnosed GBC (after cholecystectomy), re-operation with radical intent should be offered to sufficiently fit patients with stage T1b disease, provided there is no metastatic spread.
Resection of some or all of segment IVb/V of the liver is carried out together with a lymphadenectomy of the hepatoduodenal ligament.
Resection of the port sites may also be considered if the gallbladder was not removed with a bag or if the gallbladder was perforated.
Basic surgical principles apply, thus resection with no tumour at the margin (R0) is the aim.
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