Benchmarks and Geographic Differences in Gallbladder Cancer Surgery: An International Multicenter Study.
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Vega Eduardo A, Newhook Timothy E, Mellado Sebastian, Ruzzenente Andrea, Okuno Masayuki, De Bellis Mario, Panettieri Elena, Ahmad M Usman, Merlo Ignacio, Rojas Jesus, De Rose Agostino M, Nishino Hiroto, Sinnamon Andrew J, Donadon Matteo, Hauger Marit S, Guevara Oscar A, Munoz Cesar, Denbo Jason W, Chun Yun Shin, Tran Cao Hop S, Sanchez Claria Rodrigo, Tzeng Ching-Wei D, De Aretxabala Xabier, Vivanco Marcelo, Brudvik Kristoffer W, Seo Satoru, Pekolj Juan, Poultsides George A, Torzilli Guido, Giuliante Felice, Anaya Daniel A, Guglielmi Alfredo, Vinuela Eduardo, Vauthey Jean-Nicolas
Аннотация
PATIENTS AND METHODS: This study included consecutive patients with GBC who underwent curative-intent surgery during 2000-2021 at 13 centers, across seven countries and four continents. Patients operated on at high-volume centers without the need for vascular and/or bile duct reconstruction and without significant comorbidities were chosen as the benchmark group.
RESULTS: Of 906 patients who underwent curative-intent GBC surgery during the study period, 245 (27%) were included in the benchmark group. These were predominantly women (n = 174, 71%) and had a median age of 64 years (interquartile range 57-70 years). In the benchmark group, 50 patients (20%) experienced complications within 90 days after surgery, with 20 patients (8%) developing major complications (Clavien-Dindo grade ≥ IIIa). Median length of postoperative hospital stay was 6 days (interquartile range 4-8 days). Benchmark values included ≥ 4 lymph nodes retrieved, estimated intraoperative blood loss ≤ 350 mL, perioperative blood transfusion rate ≤ 13%, operative time ≤ 332 min, length of hospital stay ≤ 8 days, R1 margin rate ≤ 7%, complication rate ≤ 22%, and rate of grade ≥ IIIa complications ≤ 11%.
CONCLUSIONS: Surgery for GBC remains associated with significant morbidity. The availability of benchmark values may facilitate comparisons in future analyses among GBC patients, GBC surgical approaches, and centers performing GBC surgery.