Introduction : Cystic lymph node (CLN) is located around the infundibulum of gallbladder and receives blood from cystic artery. We made a hypothesis that CLN can play a role of a sentinel lymph node of gallbladder cancer.

Methods : From Feb 2018 to Dec 2018 we harvested a CLN from laparoscopic cholecystectomy specimens of any diagnosis to investigate its identifications rate. To include CLN in the specimen, we tried to expose the right side of common hepatic duct (CHD) when possible. Cases were divided into 5 groups according to Parkland scale which evaluates the severity of inflammation. For cases of GB cancer (GBC), we removed lymph nodes #8, #12, and #13. Malignant cells in the CLN and the other lymph nodes was investigated to analyze the rate of skip metastasis.

Results : We performed 193 laparoscopic cholecystectomies. In 28 cases exposure of the right side of CHD was impossible due to inflammation or fibrosis. In these group identification rate of CLN was 32.1% (9/28). In the other cases in which the right side of CHD was exposed, identification rate was 81.8% (135/165). Identification rate of CLN was similar between 5 groups of Parkland scale (78.8%, 81.2%, 77.6%, 50.5%, and 68.8%, respectively; p=0.100). In 11 cases of GBC, there were no case of skip metastasis

Conclusions : Identification rate of CLN was high enough for clinical application when the right side of CHD was exposed. There was no case of skip metastasis but higher number of study should be carried out in the future to confirm this finding.