Xu XQ, Liu W, Li BL, Hong T, Zheng CJ, He XD, Liao Q, Zhao YP. Unsuspected gallbladder cancer management during or after laparoscopic cholecystectomy.
Shijie Huaren Xiaohua Zazhi 2009;
17:1312-1317. [DOI:
10.11569/wcjd.v17.i13.1312]
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Abstract
AIM: To explore the effectiveness of surgeons in determining the unsuspected gallbladder carcinoma (UGC) at laparoscopic cholecystectomy (LC) and the management of UGC.
METHODS: A total of 6429 patients with gallbladder disease were included in this study who underwent LC during June, 1989 and November, 2008. Patients with UGC were reviewed retrospectively to assess preoperative diagnosis, intraoperative findings and outcomes.
RESULTS: Of the total patients, 27 in 6429 (0.4%) were histopathologically diagnosed as UGC during (17) or after (10) LC. The tumor stages of the 27 diagnosed were pT1 (9), pT2 (9), and pT3 (91), each with 9 cases. The survival rates of all the UCG patients in one-year, three-year and five-year were 74.1%, 63% and 59.3%, respectively. The five-year survival rates of pT1 stage, pT2 stage and pT3 stage were 100%, 66.7% and 0.0%, respectively, not significantly affected by whether the patients had been diagnosed with UGC during or after LC (P < 0.05).
CONCLUSION: The survival rate from UGC is associated with tumor stage and it is confirmed that a carefully performed LC is adequate treatment for pT1 stage cancer. If a suspicious lesion is found, intraoperative frozen section is performed for pathological examination. However, radical operation is recommended for T2 patients and effective measures should be taken to avoid tumor implant and metastasis.
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