Laparoscopic radical hepatectomy and lymphadenectomy for incidental gallbladder cancer. Surgical technique with ICG fluorescence enhancement

Background: Radical re-resection has been demonstrated beneficial in incidental gallbladder cancer (iGBC) stages ≥ pT1b [1]. Anatomical resection (AR) of segments IVb-V is recommended, particularly for iGBC and liver-sided tumors [2]. Laparoscopically, this is a challenging procedure, as well as the...

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Autores: Lujan-Mompean, J.A. (Juan Antonio)|||/items/b4a060c5-62c8-43d9-bc5b-cba51360d4fd, Fusco-Almeida, A.M. (Ana Marisa)|||/items/26944356-a9cc-496b-9ce4-8f4fab7c7709, López-Olaondo, L. (Luis Alberto)|||/items/89e198d0-61ef-4f10-9eaa-debda2107e32, Rotellar-Sastre, F. (Fernando)|||/items/833cb788-f4b9-404d-a18b-ae1c84369b51
Tipo de recurso: artículo
Fecha de publicación:2022
País:España
Institución:Universidad de Navarra
Repositorio:Dadun. Depósito Académico Digital de la Universidad de Navarra
Idioma:inglés
OAI Identifier:oai:dadun.unav.edu:10171/63738
Acceso en línea:https://hdl.handle.net/10171/63738
Access Level:acceso abierto
Palabra clave:Gallbladder cancer
Hepatectomy
Lymphadenectomy
Laparoscopic surgery
Anatomical resection
Indocyanine green
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spelling Laparoscopic radical hepatectomy and lymphadenectomy for incidental gallbladder cancer. Surgical technique with ICG fluorescence enhancementLujan-Mompean, J.A. (Juan Antonio)|||/items/b4a060c5-62c8-43d9-bc5b-cba51360d4fdFusco-Almeida, A.M. (Ana Marisa)|||/items/26944356-a9cc-496b-9ce4-8f4fab7c7709López-Olaondo, L. (Luis Alberto)|||/items/89e198d0-61ef-4f10-9eaa-debda2107e32Rotellar-Sastre, F. (Fernando)|||/items/833cb788-f4b9-404d-a18b-ae1c84369b51Gallbladder cancerHepatectomyLymphadenectomyLaparoscopic surgeryAnatomical resectionIndocyanine greenBackground: Radical re-resection has been demonstrated beneficial in incidental gallbladder cancer (iGBC) stages ≥ pT1b [1]. Anatomical resection (AR) of segments IVb-V is recommended, particularly for iGBC and liver-sided tumors [2]. Laparoscopically, this is a challenging procedure, as well as the regional lymphadenectomy, since inflammation from previous surgery can hinder identification of extrahepatic bile ducts. This difficult minimally invasive procedure, facilitated with indocyanine green (ICG) fluorescence enhancement [3] is herein didactically demonstrated. Methods: A 73 y. o. female patient underwent laparoscopic cholecystectomy for cholelithiasis. An iGBC -pT2b with positive cystic node-was found. Completion radical surgery was decided. Before surgery, 1.5mg of ICG was intravenously administered. A regional lymphadenectomy (stations 5-8-9-12-13) was safely performed: ICG allowed for bile duct visualization despite scarring from previous procedure. AR (IVb-V) was performed based on a glissonian-pedicle approach. After completing the procedure, a new dose of ICG was administered to discard ischemic areas in the remnant. Results: Total operative time was 359 min. Intermittent Pringle maneuver resulted in <50 ml bleeding. Hospital stay was 3 days. Pathological examination revealed no residual tumor in the liver bed. Ten lymph nodes were resected; 3 of them (2 retroportal and 1 common hepatic artery) showing tumoral invasion. After surgery, 6 cycles of adjuvant chemotherapy (Gemcitabine-Oxaliplatin) was administered. Conclusions: Laparoscopic radical surgery (AR of segments IVb-V plus regional lymphadenectomy) for iGBC is feasible and safe [4]. ICG fluorescence can be of help to identify hilar structures and rule out areas of ischemia.ElsevierDadun. Depósito Académico Digital Universidad de Navarra20222022-06-2920222022-01-0120222022-01-01journal articlehttp://purl.org/coar/resource_type/c_6501info:eu-repo/semantics/articleapplication/pdfhttps://hdl.handle.net/10171/63738reponame:Dadun. Depósito Académico Digital de la Universidad de Navarrainstname:Universidad de NavarraInglésengopen accesshttp://purl.org/coar/access_right/c_abf2info:eu-repo/semantics/openAccessoai:dadun.unav.edu:10171/637382026-06-21T12:47:57Z
dc.title.none.fl_str_mv Laparoscopic radical hepatectomy and lymphadenectomy for incidental gallbladder cancer. Surgical technique with ICG fluorescence enhancement
title Laparoscopic radical hepatectomy and lymphadenectomy for incidental gallbladder cancer. Surgical technique with ICG fluorescence enhancement
spellingShingle Laparoscopic radical hepatectomy and lymphadenectomy for incidental gallbladder cancer. Surgical technique with ICG fluorescence enhancement
Lujan-Mompean, J.A. (Juan Antonio)|||/items/b4a060c5-62c8-43d9-bc5b-cba51360d4fd
Gallbladder cancer
Hepatectomy
Lymphadenectomy
Laparoscopic surgery
Anatomical resection
Indocyanine green
title_short Laparoscopic radical hepatectomy and lymphadenectomy for incidental gallbladder cancer. Surgical technique with ICG fluorescence enhancement
title_full Laparoscopic radical hepatectomy and lymphadenectomy for incidental gallbladder cancer. Surgical technique with ICG fluorescence enhancement
title_fullStr Laparoscopic radical hepatectomy and lymphadenectomy for incidental gallbladder cancer. Surgical technique with ICG fluorescence enhancement
title_full_unstemmed Laparoscopic radical hepatectomy and lymphadenectomy for incidental gallbladder cancer. Surgical technique with ICG fluorescence enhancement
title_sort Laparoscopic radical hepatectomy and lymphadenectomy for incidental gallbladder cancer. Surgical technique with ICG fluorescence enhancement
dc.creator.none.fl_str_mv Lujan-Mompean, J.A. (Juan Antonio)|||/items/b4a060c5-62c8-43d9-bc5b-cba51360d4fd
Fusco-Almeida, A.M. (Ana Marisa)|||/items/26944356-a9cc-496b-9ce4-8f4fab7c7709
López-Olaondo, L. (Luis Alberto)|||/items/89e198d0-61ef-4f10-9eaa-debda2107e32
Rotellar-Sastre, F. (Fernando)|||/items/833cb788-f4b9-404d-a18b-ae1c84369b51
author Lujan-Mompean, J.A. (Juan Antonio)|||/items/b4a060c5-62c8-43d9-bc5b-cba51360d4fd
author_facet Lujan-Mompean, J.A. (Juan Antonio)|||/items/b4a060c5-62c8-43d9-bc5b-cba51360d4fd
Fusco-Almeida, A.M. (Ana Marisa)|||/items/26944356-a9cc-496b-9ce4-8f4fab7c7709
López-Olaondo, L. (Luis Alberto)|||/items/89e198d0-61ef-4f10-9eaa-debda2107e32
Rotellar-Sastre, F. (Fernando)|||/items/833cb788-f4b9-404d-a18b-ae1c84369b51
author_role author
author2 Fusco-Almeida, A.M. (Ana Marisa)|||/items/26944356-a9cc-496b-9ce4-8f4fab7c7709
López-Olaondo, L. (Luis Alberto)|||/items/89e198d0-61ef-4f10-9eaa-debda2107e32
Rotellar-Sastre, F. (Fernando)|||/items/833cb788-f4b9-404d-a18b-ae1c84369b51
author2_role author
author
author
dc.contributor.none.fl_str_mv Dadun. Depósito Académico Digital Universidad de Navarra
dc.subject.none.fl_str_mv Gallbladder cancer
Hepatectomy
Lymphadenectomy
Laparoscopic surgery
Anatomical resection
Indocyanine green
topic Gallbladder cancer
Hepatectomy
Lymphadenectomy
Laparoscopic surgery
Anatomical resection
Indocyanine green
description Background: Radical re-resection has been demonstrated beneficial in incidental gallbladder cancer (iGBC) stages ≥ pT1b [1]. Anatomical resection (AR) of segments IVb-V is recommended, particularly for iGBC and liver-sided tumors [2]. Laparoscopically, this is a challenging procedure, as well as the regional lymphadenectomy, since inflammation from previous surgery can hinder identification of extrahepatic bile ducts. This difficult minimally invasive procedure, facilitated with indocyanine green (ICG) fluorescence enhancement [3] is herein didactically demonstrated. Methods: A 73 y. o. female patient underwent laparoscopic cholecystectomy for cholelithiasis. An iGBC -pT2b with positive cystic node-was found. Completion radical surgery was decided. Before surgery, 1.5mg of ICG was intravenously administered. A regional lymphadenectomy (stations 5-8-9-12-13) was safely performed: ICG allowed for bile duct visualization despite scarring from previous procedure. AR (IVb-V) was performed based on a glissonian-pedicle approach. After completing the procedure, a new dose of ICG was administered to discard ischemic areas in the remnant. Results: Total operative time was 359 min. Intermittent Pringle maneuver resulted in <50 ml bleeding. Hospital stay was 3 days. Pathological examination revealed no residual tumor in the liver bed. Ten lymph nodes were resected; 3 of them (2 retroportal and 1 common hepatic artery) showing tumoral invasion. After surgery, 6 cycles of adjuvant chemotherapy (Gemcitabine-Oxaliplatin) was administered. Conclusions: Laparoscopic radical surgery (AR of segments IVb-V plus regional lymphadenectomy) for iGBC is feasible and safe [4]. ICG fluorescence can be of help to identify hilar structures and rule out areas of ischemia.
publishDate 2022
dc.date.none.fl_str_mv 2022
2022-06-29
2022
2022-01-01
2022
2022-01-01
dc.type.none.fl_str_mv journal article
http://purl.org/coar/resource_type/c_6501
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://hdl.handle.net/10171/63738
url https://hdl.handle.net/10171/63738
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Elsevier
publisher.none.fl_str_mv Elsevier
dc.source.none.fl_str_mv reponame:Dadun. Depósito Académico Digital de la Universidad de Navarra
instname:Universidad de Navarra
instname_str Universidad de Navarra
reponame_str Dadun. Depósito Académico Digital de la Universidad de Navarra
collection Dadun. Depósito Académico Digital de la Universidad de Navarra
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,300719

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