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Gallbladder removal, or cholecystectomy, is the most common surgical procedure in the United States, with more than 500,000 performed every year. Even though gallbladder surgery is common, it matters where patients have this particular procedure done. AdventHealth Tampa Digestive Institute’s Advanced HPB (hepatopancreatobiliary) Surgeons offer distinct advantages to patients who require gallbladder surgery, whether for gallstones, chronic inflammation, poor gallbladder function or gallbladder cancer.
Checking for Gallbladder Cancer During a Cholecystectomy
Whenever a patient has a tumor or part of an organ system surgically removed, it is standard to check for the presence of cancer or precancerous changes. In the vast majority of centers, this is done after the surgery, when the removed tissue has been sent to a hospital’s pathology department. There, a specialist called a pathologist who looks at various cross sections of the surgically removed tissue under a microscope to determine whether or not cancer cells are present.
In such a setup, patients with gallbladder cancer usually learn of their diagnosis about a week to 10 days after their procedure. However, because they are still recovering from their recent cholecystectomies, it is not an ideal time for further surgery to diagnose and treat gallbladder cancer if found by the pathologist. In some cases, patients must even wait another four to six weeks until they are well enough to have a second procedure that can help surgeons assign a what is called a stage to the cancer and treat it. Stage indicates the size of the tumor and whether or not it has spread to the surrounding lymph nodes or other distant organs. The stage helps surgeons determine a patient’s best treatment plan. While patients wait to be well enough for a second operation, their cancer tumors may grow because the immune system is temporarily suppressed from the stress of the first operation.
This process works differently at the Digestive Institute because Advanced HPB Surgeons Sharona Ross, MD, FACS, Alexander Rosemurgy, MD, FACS, and Iswanto Sucandy, MD, FACS, have extensive experience in treating cancers of the digestive tract. As soon as they remove a patient’s gallbladder during a routine cholecystectomy – a common treatment for gallstones – the Digestive Institute surgeon opens up the gallbladder to make sure it looks normal and does not have signs of tumor growth within the gallbladder wall. If the specimen looks normal, it is sent to pathology just as it would be at other centers. However, if gallbladder tissue looks abnormal, the surgeon sends a frozen section to the pathology department to have it examined immediately.
From Routine Cholecystectomy to Gallbladder Cancer Surgery
If pathology determines that patient has gallbladder cancer, then the surgeon performs cancer surgery right away in the same sitting while the patient is still under anesthesia. This not only saves time in treating gallbladder cancer, lending to peace of mind, but patients are also spared from a second, separate surgery and recovery.
At AdventHealth Tampa’s Digestive Institute, most gallbladder removals are performed as laparoscopic endoscopic single-site surgery (LESS), an approach in which patients receive a single incision in their belly buttons that leaves them without a visible scar. If the surgeon discovers a patient has gallbladder cancer during a LESS cholecystectomy, the procedure is converted into a robotic procedure with the da Vinci® Surgical System. While this approach requires four surgical incisions, it is still a minimally invasive procedure that allows patients to recover more quickly, with less pain and chance for postoperative complications.
Minimally Invasive Gallbladder Cancer Surgery at the Digestive Institute Tampa
Whether gallbladder cancer is diagnosed during a cholecystectomy or through imaging before surgery (usually a CT scan for a gallbladder or central liver mass), surgical treatment at the Digestive Institute is similar. Dr. Sucandy and Dr. Rosemurgy are the Institute’s dedicated gallbladder cancer surgeons. In addition to removing the gallbladder, these surgeons use the da Vinci robot to remove lymph nodes near the gallbladder, liver and bile duct as well as part of the liver to which the gallbladder was attached. Most other centers perform liver surgery and gallbladder cancer surgery as an open procedure that leaves the patient with a large abdominal scar and longer recovery. At the AdventHealth Tampa Digestive Institute, most patients can have liver, gallbladder and bile duct cancer surgery as a closed, minimally invasive operation. This significantly eases their recoveries.
The goal of gallbladder cancer surgery is to remove all of the tumor. This requires the surgeons to work closely with a pathologist during the operation to ensure that the surgeon has taken out enough cancer-free liver tissue (known as margins) surrounding the gallbladder cancer. In about five business day, the surgeon receives a final pathology report. He or she will use information about tumor size, margin status and whether the removed lymph nodes contain tumor cells to determine if further treatment such as chemotherapy or radiation therapy is needed.
The Ideal Center for Gallbladder Surgery in Tampa
Because the Advanced HPB Surgeons at the AdventHealth Tampa Digestive Institute perform both routine cholecystectomy and treat gallbladder cancer, the Digestive Institute is an optimal place to have gallbladder surgery. Even if other centers were able to diagnose gallbladder cancer during a cholecystectomy, they would not have the state-of-the-art robotic resources and the high-level expertise required to offer complex definitive surgery for gallbladder cancer in a minimally invasive fashion. Other centers that offer high-level care for liver, gallbladder and bile duct cancer (still mostly via open surgery), do not offer routine cholecystectomy. This makes the Digestive Institute an ideal choice for anyone who needs America’s most common surgical procedure.
If you or a loved one needs gallbladder surgery, learn about the difference AdventHealth Digestive Institute Tampa’s Advanced HPB Surgeons can make. For an appointment, call