In our clinic we do a resection of the galbladder en block with at least a rim of the adjacent livertissue and palpable lymphnodes. We do this in an open approach.

It would completely depend on your experience of laparoscopic liver resection, the stage of gallbladder cancer to be treated and the confidence in cross-sectional imaging in determing this to be a definite gallbladder cancer. Wright GP et  (JSLS. 2013

Oct-Dec;17(4):596-601) report that up to 50% of suspected GBCs turn out to be benign disease, suggesting that an inital laparoscpoic approach (with frozen-section in my opinion) could be useful. Goetze et al (Surg Endosc. 2013

Aug;27(8):2821-8.) also reported that the method of primary access technique does not influence prognosis (i.e. lap, open or lap to open). I think the key is to achieve an R0 resection without breaching the margin of the mass, if this cannot be achieved lap then open from the start is better. Personally, for radical gallbaldder cancer resections requiring EHD resection, my preferred approach would be open from the outset.

In our clinic, we practice 3 terapeutic ways:

1. in case of  high preoperative suspicion of galbladder cancer we also perform a laparotomy for resection of the galbladder en block with at least a rim  of the adjacent livertissue and palpable lymphnodes. 

2. in case of hystological definition of cancer after cholecystectomy performed for lilthiasis, we do a open resection of 5 liver segment

3. in case of intraoperative clinical suspicion during laparoscopic cholecistectomy of galbladeer cancer, we convert always in laparotomy for surgical treatment as reported in point 1. 

In our experience, doing acute care surgery even in cholecystectomies, we get the diagnosis of cancer almost always two-three weeks after surgery. In that case we recall patients for an open surgery

Redical resection of the gall bladder for cancer necessitate resection of rim of liver tissue surrounding the bed of the gall bladder, in our center we used to do it through open laparotomy in both situations ( if diagnosed pre operatively or histologically after cholecystectomy) provided that the there are no mets or distant lymph nodes.