Introduction Minimally invasive techniques in digestive diseases are widely used, but there is controversy which surrounds the management of early gall bladder cancer by this technique. True benefits of laparoscopy are well established but there are certain disadvantages also which are the cause of fear and thus lesser acceptance of laparoscopy for radical cholecystectomy for t1b or more advanced gall bladder cancers. Discussion gall bladder lacks submucosal layer and has very thin proper muscle layer leading to rapid invasion of nearby structures and metastasis causing advanced disease on detection and hence poor survival. Latest evidence suggests similar survival if we compare open and laparoscopic approach making it evident that type of surgery do not reflect survival. Latest studies on better instrumentation and technical advances are showing similar survival in both groups, making laparoscopy nowadays as the standard of care. Liver resection and lymphadenectomy are the two technically challenging components of this type of surgery which are now well established in studies done on other gastrointestinal and hepatobiliary cancers. Conclusion In conclusion, laparoscopic approach is safe and beneficial for patients with t1b/t2 gallbladder carcinoma.
Ashutosh Gupta, Amit Choraria, Shantanu Tiwari, Sourabh Nandi, Vivek Chaudhary