RT Journal
A1 Polk, Jr HC
T1 STrategies for surgical treatment of gallbladder carcinoma based on information available before resection—invited critique
JF Archives of Surgery
JO Archives of Surgery
YR 2003
FD July 1
VO 138
IS 7
SP 750
OP 750
DO 10.1001/archsurg.138.7.750
UL http://dx.doi.org/10.1001/archsurg.138.7.750
AB 
Kokudo and colleagues report a massive and expensive effort to preoperatively stage patients with gallbladder cancer referred to a hospital specialized in treating patients with cancer. To some extent, they and their data are victims of referral bias. The current application of their conclusions to most patients being evaluated for biliary surgery worldwide is not feasible due to the dominance of the twin tenets of minimal access and cost control. Furthermore, the extensive work-up and precise extended operations where indicated still create a very low yield of well patients in the long run.