Radical cholecystectomy for gallbladder cancer: Real-world applicability of perioperative and oncologic ‘benchmarks’

Objectives: There is reasonable consensus on nomenclature and technical aspects of radical cholecystectomy (RC) for gallbladder cancer (GBC). However, the surgical quality parameters of the procedure has not been adequately defined. A recent study from 13 high-volume centres has proposed ‘Benchmarks’ (‘75th percentile of median’) as the best achievable RC outcomes in 8 perioperative and oncologic domains in low-risk GBC patients. At a tertiary care centre in India, we evaluated these benchmarks for RC and extended RC (ERC). Material and Methods: Retrospective analysis of consecutive GBC patients who underwent surgery from 2013 to 2023. Perioperative and oncologic outcomes were compared to proposed benchmark values. Results: Over 10-years, 51 GBC patients underwent surgery with curative intent. At diagnostic laparoscopy, 12 (23.5%) had peritoneal metastases and were excluded from further analysis. The remaining 39 patients (10 males: 29 females; median age 57 years) underwent radical cholecystectomy for GBC. Complications ClavienDindo grade III occurred in 1 (2.6%) patient. Of 39 patients, 37 (94.87%) had R0 resection. Median lymph nodes retrieved was 8 (1-20). Lymph nodes ≥4 & ≥6 were retrieved in 36 (92.3%) & 34 (87.2%) patients, respectively. Thirty-one patients (25 low-risk) had RC, and benchmarks were achieved in all 08 domains. In the ERC group ( n = 8), benchmarks were achieved for two oncologic parameters and for the length of stay, and blood loss. Conclusion: Benchmarks provide a valuable tool for the standardisation of outcomes following RC. However, ≥6 lymph nodes harvested may be a more appropriate benchmark value at high-volume endemic centres.