Diagnosis and Treatment of Unexpected Gallbladder Carcinoma During Laparoscopic Cholecystectomy
10.3969/j.issn.1009-6604.2016.09.024
- VernacularTitle:腹腔镜胆囊手术中意外胆囊癌的诊治对策
- Author:
Xin AN
;
Bingchuan XUE
;
Wenlong ZHANG
- Publication Type:Journal Article
- Keywords:
Laparoscopic cholecystectomy;
Unexpected gallbladder cancer
- From:
Chinese Journal of Minimally Invasive Surgery
2016;16(9):858-859
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore clinical characteristics and treatment for unexpected gallbladder carcinoma during laparoscopic surgery . Methods A retrospective analysis was made on clinical data of 12 cases of unexpected gallbladder carcinoma out of 4620 cases of laparoscopic cholecystectomy (LC) in our hospital from September 1997 to September 2015.Intraoperative frozen pathological diagnosis showed gallbladder cancer Nevin stage Ⅲin 1 case, and a conversion to open surgery of gallbladder cancer was conducted .The remaining 11 cases of gallbladder carcinoma were diagnosed by pathology after surgery .One case of Nevin stage Ⅰand 1 case of stage Ⅱwere not surgically treated .Of the other 9 cases of Nevin stage Ⅲ, there were 5 patients who refused surgery and 4 patients received open radical resection of gallbladder cancer at 10-18 d (mean, 14 d) postoperatively. Results The 5 cases of Nevin stage Ⅲwho refused open radical surgery were lost to follow-up.Two cases of stage Ⅰand Ⅱwere followed up for 63 months and 6 months after LC without recurrence .Of the 5 cases of stageⅢundergoing open radical surgery , 2 cases dead at 8 and 10 months postoperatively because of abdominal extensive metastasis and cachexia , and 3 cases dead at 10, 28, and 32 months postoperatively because of gallbladder carcinoma liver transfer . Conclusions The occurrence of unexpected gallbladder cancer should be taken into consideration during laparoscopic cholecystectomy .Timely and appropriate complementary therapy should be given .