Abstract
Background/Purpose
Many cases have been reported of disastrous port-site recurrence after laparoscopic cholecystectomy (LC) revealed unsuspected gallbladder carcinoma (GBC). Some investigators have reported that the prognosis of patients after LC showed unsuspected GBC is not worsened by laparoscopic procedures. We retrospectively reviewed our cases and the literature to reconfirm the intrinsic risks of LC for unsuspected GBC.
Methods
Of 1663 patients who underwent LC from January 1991 to December 2003 in a single institution, 9 (0.54%) with unsuspected GBC were reviewed.
Results
These 9 patients consisted of 5 men and 4 women, whose ages ranged from 58 to 87 years, with a median age of 73 years. Two patients with a pT1a tumor (limited to mucosa) and 2 patients with a pT1b tumor (muscle layer) underwent no further operation. The remaining 5 patients with a pT2 tumor (subserosa) underwent further operations with lymph node dissection. Five patients (2 patients with pT1b and 3 patients with pT2) developed recurrence and all of them died within a median period of 19 months (range 14–37 months) after LC. The causes of death were bone metastases in 1 patient (pT2), local recurrence in 2 patients (pT1b and pT2), and peritoneal metastasis in 2 patients (one elderly patient with pT1b who underwent laparoscopic common bile duct exploration, and one patient with pT2 in whom the cystic duct was damaged during surgery). Four patients (2 with pT1 and 2 with pT2) have been doing well with a median follow-up of 39.5 months (range 12–99 months) after LC.
Conclusions
Surgeons should always prevent bile spillage during LC and when removing the resected gallbladder. When laparoscopic common bile duct exploration is planned, especially for elderly women, surgeons should also bear in mind the increasing possibility of unsuspected GBC.
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References
F Dubois P Icard G Berthelot H Levard (1990) ArticleTitleCoelioscopic cholecystectomy. Preliminary report of 36 cases Ann Surg 211 60–2 Occurrence Handle2294845
LA Wibbenmeyer TP Wade RC Chen RC Meyer RP Turgeon CH Andrus (1995) ArticleTitleLaparoscopic cholecystectomy can disseminate in situ carcinoma of the gallbladder J Am Coll Surg 181 504–10 Occurrence Handle7582223
V Paolucci B Schaeff M Schneider C Gutt (1999) ArticleTitleTumor seeding following laparoscopy: international survey World J Surg 23 989–97 Occurrence Handle10.1007/s002689900613 Occurrence Handle10512937
DG Clair DB Lautz DC Brooks (1992) ArticleTitleRapid development of umbilical metastases after laparoscopic cholecystectomy for unsuspected gallbladder carcinoma Surgery 113 355–8
RG Figueiras MD Tie JAL Villarroya MJA Fernandez AAG Rodriguez MA Pintos (1999) ArticleTitlePort-site metastases after laparoscopic cholecystectomy for an unexpected gallbladder carcinoma Abdom Imaging 24 404–6 Occurrence Handle10.1007/s002619900524 Occurrence Handle10390567
F Drouard J Delamarre JP Capron (1991) ArticleTitleCutaneous seeding of gallbladder cancer after laparoscopic cholecystectomy N Engl J Med 325 1316
O Lundberg Kristoffersson (1999) ArticleTitlePort-site metastases from gallbladder cancer after laparoscopic cholecystectomy. Results of a Swedish survey and review of published reports Eur J Surg 165 215–22 Occurrence Handle10.1080/110241599750007072 Occurrence Handle10231654
PR Yenumula WG Sheridan (2000) ArticleTitlePort-site metastasis following laparoscopic cholecystectomy: a review of the literature and a case report Eur J Surg Oncol 26 95–102 Occurrence Handle10.1053/ejso.1999.0748 Occurrence Handle10718188
HM Jeon JS Kim CD Lee EK Kim SN Kim JS Kim (1999) ArticleTitleLate development of umbilical metastasis after laparoscopic cholecystectomy for a gallbladder carcinoma Oncol Rep 6 283–7 Occurrence Handle10022990
MA Fusco MW Paluzzi (1993) ArticleTitleAbdominal wall recurrence after laparoscopic-assisted colectomy for adenocarcinoma of the colon Dis Colon Rectum 36 858–61 Occurrence Handle10.1007/BF02047384 Occurrence Handle8397078
ES Hughes FT McDermott AI Polglase WR Johnson (1983) ArticleTitleTumor recurrence in the abdominal wall scar after large bowel cancer surgery Dis Colon Rectum 26 571–2 Occurrence Handle6223795
SD Wexner SM Cohen (1995) ArticleTitlePort-site metastases after laparoscopic colorectal surgery for cure of malignancy Br J Surg 82 295–8 Occurrence Handle7795990
K Suzuki T Kimura H Ogawa (2000) ArticleTitleLong-term prognosis of gallbladder cancer diagnosed after laparoscopic cholecystectomy Surg Endosc 14 712–6 Occurrence Handle10.1007/s004640000145 Occurrence Handle10954815
K Suzuki T Kimura H Ogawa (1998) ArticleTitleIs laparoscopic cholecystectomy hazardous for gallbladder cancer? Surgery 123 311–4 Occurrence Handle10.1067/msy.1998.85938 Occurrence Handle9526523
T Yoshida T Matsumoto Morii Y Sasaki T Ishio T Bandoh et al. (2000) ArticleTitleLaparoscopic cholecystectomy in the treatment of patients with gallbladder cancer J Am Coll Surg 191 158–63 Occurrence Handle10.1016/S1072-7515(00)00285-4 Occurrence Handle10945359
InstitutionalAuthorNameAmerican Joint Committee on Cancer (1997) AJCC cancer staging manual EditionNumber5th edn. JB Lippincott Philadelphia 103–8
K Yamaguchi K Chijiiwa H Ichimiya M Sada K Kawakami F Nishikata et al. (1996) ArticleTitleGallbladder carcinoma in the era of laparoscopic cholecystectomy Arch Surg 131 981–4 Occurrence Handle8790169
L Sarli S Contini G Sansebastiano S Gobbi R Costi L Roncoroni (2000) ArticleTitleDose laparoscopic cholecystectomy worsen the prognosis of unsuspected gallbladder cancer? Arch Surg 135 1340–4 Occurrence Handle10.1001/archsurg.135.11.1340 Occurrence Handle11074893
K Z'graggen S Birrer CA Maurer H Wehrli C Klaiber HU Baer (1998) ArticleTitleIncidence of port-site recurrence after laparoscopic cholecystectomy for preoperatively unsuspected gallbladder carcinoma Surgery 124 831–8 Occurrence Handle10.1067/msy.1998.90364 Occurrence Handle9823395
AE Ricardo BW Feig LM Ellis KK Hunt SA Culrey BV MacFadyen et al. (1997) ArticleTitleGallbladder cancer and trocar site recurrences Am J Surg 174 619–23 Occurrence Handle10.1016/S0002-9610(97)00178-5 Occurrence Handle9409585
O Lundberg A Kristofferson (2000) ArticleTitleWound recurrence from gallbladder cancer after open cholocystectomy Surgery 127 296–300 Occurrence Handle10.1067/msy.2000.104487 Occurrence Handle10715985
ND Bouvy RL Marquet H Jeekel HJ Bonjer (1996) ArticleTitleImpact of gas(less) laparoscopy and laparotomy on peritoneal tumor growth and abdominal wall metastases Ann Surg 224 694–701 Occurrence Handle10.1097/00000658-199612000-00005 Occurrence Handle8968224
CA Jacobi R Sabat B Böhm HU Zieren HD Volk JM Müller (1997) ArticleTitlePneumoperitoneum with carbon dioxide stimulates growth of malignant colonic cells Surgery 121 72–8 Occurrence Handle10.1016/S0039-6060(97)90185-9 Occurrence Handle9001554
C Wullstein G Woeste S Barkhausen E Gross UT Hopt (2002) ArticleTitleDo complications related to laparoscopic cholecystectomy influence the prognosis of gallbladder cancer? Surg Endosc 16 828–32 Occurrence Handle10.1007/s00464-001-9085-7 Occurrence Handle11997831
DH Birkett (1995) ArticleTitleSpilled cells, spilled clips, spilled stones. New problems or old challenges Surg Endosc 9 269–71 Occurrence Handle10.1007/BF00187766 Occurrence Handle7597596
Y Shirai K Yoshida K Tsukada T Muto (1992) ArticleTitleInapparent carcinoma of the gallbladder — an appraisal of a radical second operation after simple cholecystectomy Cancer 62 1422–32
RS Jones (1990) ArticleTitleCarcinoma of the gallbladder Surg Clin N Am 70 1419–28 Occurrence Handle2247823
H Tokumura A Umezawa H Cao N Sakamoto Y Imaoka A Ouchi et al. (2002) ArticleTitleLaparoscopic management of common bile duct stones: transcystic approach and choledochotomy J Hepatobiliary Pancreat Surg 9 206–12 Occurrence Handle10.1007/s005340200020 Occurrence Handle12140608
DM Lauter EJ Froines (2000) ArticleTitleLaparoscopic common duct exploration in the management of choledocholithiasis Am J Surg 179 372–4 Occurrence Handle10.1016/S0002-9610(00)00368-8 Occurrence Handle10930482
K Ouchi J Mikuni Y Kakugawa (2002) ArticleTitleOrganizing committee, 30th Annual Congress of the Japanese Society of Biliary Surgery. Laparoscopic cholecystectomy for gallbladder carcinoma: results of a Japanese survey of 498 patients J Hepatobiliary Pancreat Surg 9 256–60 Occurrence Handle10.1007/s005340200028 Occurrence Handle12140616
Y Fong N Heffernan LH Blumgart (1998) ArticleTitleGallbladder carcinoma discovered during laparoscopic cholecystectomy Cancer 83 423–7 Occurrence Handle10.1002/(SICI)1097-0142(19980801)83:3<423::AID-CNCR9>3.0.CO;2-P Occurrence Handle9690533
LJ Fligelstone RC Johnson GJ Stiff MH Wheeler (1993) ArticleTitleLaparoscopy and gastrointestinal cancer [letter Am J Surg 166 571 Occurrence Handle8238755
CC Nduka JRT Monson Menzies-Gown A Darzi (1994) ArticleTitleAbdominal wall metastases following laparoscopy Br J Surg 81 648–52 Occurrence Handle8044537
A Principe ML Lugaresi RC Lords R Golfieri MC Gallo I Bicchierri et al. (1997) ArticleTitleUnsuspected carcinoma of the gallbladder: case report of trocar-site metastasis following laparoscopic cholecystectomy Hepato-gastroenterology 44 990–3 Occurrence Handle9261587
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Yamamoto, H., Hayakawa, N., Kitagawa, Y. et al. Unsuspected gallbladder carcinoma after laparoscopic cholecystectomy. J Hepatobiliary Pancreat Surg 12, 391–398 (2005). https://doi.org/10.1007/s00534-005-0996-x
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DOI: https://doi.org/10.1007/s00534-005-0996-x