New study suggests robotic or laparoscopic surgery can be successful for gallbladder cancer surgery in select patients

Gallbladder cancer (GBC) is a rare form of cancer with no signs or symptoms in the early stages. In the U.S., approximately 2,000 people die annually from this condition, with only 20% diagnosed at an early stage. Surgery remains the most effective treatment. Although minimally invasive approaches-laparoscopic and robotic are increasingly used in gastrointestinal oncology, their use in GBC is limited and comparing robotic surgery to laparoscopic and conventional surgery approaches remains limited and controversial.

In a new review in the journal Surgical Oncology Clinics, BU researchers show that minimally invasive surgery-especially robotic surgery-can be a safe way to treat selected patients with gallbladder cancer. In the studies reviewed, robotic approaches often had less blood loss, shorter hospital stays, and sometimes removed more lymph nodes, while long‑term cancer outcomes resembled those for open surgery in appropriately chosen patients.

“Our study pulls together the newest evidence and turns it into practical, surgeon‑friendly guidance: when minimally invasive surgery may be appropriate, what key steps matter (lymph node removal and liver margin), how to follow patients after surgery and where the biggest knowledge gaps still exist like long-term results and cost,” explains corresponding author Eduardo Vega, MD, assistant professor of surgery at Boston University Chobanian & Avedisian School of Medicine.

The researchers collected and summarized research studies that compared different ways of operating for gallbladder cancer – open surgery, laparoscopic surgery and robotic surgery. They reviewed how gallbladder cancer is found (including “incidental” cancers discovered after a routine gallbladder removal), what the standard curative operation includes, what outcomes have been reported (complications, blood loss, hospital stay, lymph node yield and survival), and how recurrence happens over time. They also described a step‑by‑step setup for robotic radical gallbladder cancer surgery (positioning, trocar placement, lymph node dissection and liver resection).

According to the researchers, this review supports that robotic surgery can be a reasonable option for surgeons and cancer teams treating carefully selected gallbladder cancer patients—especially when the operation is done in experienced hepato-pancreato-biliary centers. “It also highlights what “good cancer surgery” must include: a proper liver margin, a thorough lymph node dissection (at least 6 nodes), and careful planning for incidental cases and for follow‑up imaging because recurrence is common,” adds Vega, who also is a hepato-bilio-pancreatic surgeon at Boston Medical Center. He is currently leading an international collaborative study aimed at generating more robust evidence to guide when and how robotic surgery should be used in gallbladder cancer.

Reference:

Mellado S, Rivera B, Rocca J, Review of Minimally Invasive Surgical Treatment of Gallbladder Cancer, Surgical Oncology Clinics of North America, DOI:10.1016/j.soc.2025.12.018