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- Title
CLINICOPATHOLOGICAL STUDY OF UNSUSPECTED GALLBLADDER CANCER DIAGNOSED AFTER LAPAROSCOPIC CHOLECYSTECTOMY.
- Authors
SAKAMOTO, KAZUHIRO; KITAJIMA, MASAYUKI; SHIROTA, SHIGERU; WATABE, SUGURU; OKUZAWA, ATSUSHI; MATSUDA, MITSUHIRO; ONO, KEN; KOBAYASHI, SHIGERU; KAMANO, TOSHIKI; TSURUMARU, MASAHIKO; HIRAI, SHU
- Abstract
Background: Laparoscopic cholecystectomy (LC) has become a common treatment for benign gallbladder diseases. However, this method has not been established for gallbladder cancer. Methods: In the present study, we examined the clinicopathlogical features of gallbladder cancer that was diagnosed after LC. Results: The presence of unsuspected gallbladder cancer was found in five out of 498 patients (1.00%). Preoperative diagnoses were gallstone in two, gallstone with adenomyomatosis in one, adenomyomatosis in one and gallbladder polyp in one. During LC, there was no evidence of cancer, but bile leakage occurred in two patients. Histologically, the carcinoma had invaded into the subserosa in four patients and into the mucosa in one patient. An additional operation was performed in three patients. Histological examination revealed no cancer cells in the resected liver and lymph nodes. During the average follow-up period of 47.5 months, no recurrences were observed. Although one patient died of liver metastasis 33 months later, the other three patients who underwent an additional radical operation, showed no recurrence. Conclusions: It is important to prevent port site recurrence or dissemination during LC, so a careful maneuver is required to avoid perforation of the gallbladder. At the time of bile leakage, it is best to wash around the liver bed fully to prevent recurrences of unsuspected gallbladder cancers. If gallbladder cancer has invaded the subserosa or deeper level histologically, a radical second operation should be performed as soon as possible.
- Subjects
CHOLECYSTECTOMY; GALLBLADDER cancer
- Publication
Digestive Endoscopy, 2003, Vol 15, Issue 1, p14
- ISSN
0915-5635
- Publication type
Article
- DOI
10.1046/j.1443-1661.2003.00204.x