1/35. Unexpected gallbladder cancer after laparoscopic cholecystectomy: an emerging problem? Reflections on four cases.gallbladder cancer (GC) has been reported in 0.3-1.5% of cholecystectomies. Since the introduction of laparoscopic surgery, cholecystectomies have increased and occult GC may therefore be more frequent. Herein we analyze our own experience to determine whether there was an increase in GC. We also evaluate the risk factors for this outcome. Four patients with GC undiagnosed before surgery (four of 602 cases, or 0.66%) were submitted to laparoscopic cholecystectomy. The percentage in patients who underwent open surgery was 0.28% (two of 714 cases). Without reoperation, three patients died in the laparoscopic group and one is alive at 12 months. Trocar site metastasis was not observed. Although the percentage of GC (0.28% versus 0.66%) increased, the percentage is still in the referred average. Undiagnosed GC is on the increase. Examination of the gallbladder and a frozen section, if necessary, are recommended. Calcified gallbladders, age >70 years, a long history of stones, and a thickened gallbladder all represent significant risk factors.- - - - - - - - - - ranking = 1keywords = gallbladder (Clic here for more details about this article) |
2/35. Port site metastases after laparoscopic cholecystectomy for an unexpected gallbladder carcinoma.Laparoscopic cholecystectomy is a proven, well-accepted surgical technique for removing the diseased gallbladder and has rapidly become the surgical procedure of choice over conventional open cholecystectomy. Radiologists must be aware of the possibility of inadvertent dissemination of incidental gallbladder cancer during laparoscopic cholecystectomy. We report a case of this unusual complication: a patient with port site metastases after laparoscopic cholecystectomy for an unexpected gallbladder carcinoma at an early stage.- - - - - - - - - - ranking = 1keywords = gallbladder (Clic here for more details about this article) |
3/35. Port-site metastasis after laparoscopic cholecystectomy for benign disease.We describe the case history of a patient presenting with a port-site metastasis from an occult pancreatic malignancy after laparoscopy for benign gallbladder disease. While port-site recurrence is well recognized after laparoscopy for malignant disease, its presentation after laparoscopy for benign disease is rare, this being only the third such case to be reported in the literature. It emphasizes that all pathology localizing to port sites after surgery should be investigated, as it may represent the earliest sign of a hitherto occult intra-abdominal malignancy.- - - - - - - - - - ranking = 0.14285714285714keywords = gallbladder (Clic here for more details about this article) |
4/35. Port-site metastasis following laparoscopic cholecystectomy: a review of the literature and a case report.Port-site metastasis following laparoscopic cholecystectomy with unsuspected gallbladder carcinoma is a serious problem. We reviewed 45 such cases reported in the English literature to date, and add another case which occurred in a 72-year-old female 13 months after a laparoscopic cholecystectomy for gallstones, who also had an unapparent gallbladder carcinoma. Pre-operative diagnosis of gallbladder carcinoma is possible in less than 10% of cases, with a high index of suspicion. If detected during laparoscopy early conversion to open procedure is recommended. If diagnosed later, however, to contemplate further radical operation depending on histopathology would be unwise as a universal approach, because of increased associated morbidity and mortality. The prospect of cure is also very unrealistic in this condition.- - - - - - - - - - ranking = 0.42857142857143keywords = gallbladder (Clic here for more details about this article) |
5/35. Port site recurrence of gallbladder cancer after laparoscopic surgery: two case reports of long-term survival.More than 100 patients with port site recurrence after laparoscopic procedures have been reported, and in most cases recurrence has had a fatal outcome. Two patients who survived port site recurrence of unexpected gallbladder cancer after laparoscopic cholecystectomy are reported. abdominal wall excision was performed in one patient, and thermoradiotherapy was performed in the other. Both patients have remained free of disease during long-term follow-up (82 and 45 months).- - - - - - - - - - ranking = 0.71428571428571keywords = gallbladder (Clic here for more details about this article) |
6/35. Incidental gallbladder cancer at laparoscopy: a review of two cases.Early peritoneal seeding and trocar site metastasis from gallbladder cancer have been reported after laparoscopic cholecystectomy. Nevertheless, the role of laparoscopy in gallbladder cancer remains controversial. Two cases of early recurrence of carcinoma of the gallbladder after laparoscopic cholecystectomy are described. In the first case, the use of a gasless technique did not prevent an early, diffuse peritoneal dissemination of the disease. In the second case, despite the use of a retrieval bag to extract the gallbladder, multiple metastases around the gallbladder bed and local peritoneal seeding developed. These cases demonstrate that factors other than bile spillage, CO2 inflation, and the use of a retrieval bag are responsible for early dissemination of gallbladder cancer.- - - - - - - - - - ranking = 1.4285714285714keywords = gallbladder (Clic here for more details about this article) |
7/35. Late-type recurrence at the port site of unexpected gallbladder carcinoma after a laparoscopic cholecystectomy: report of a case.A 73-year-old woman had a laparoscopic cholecystectomy for unexpected gallbladder cancer and 9 days later underwent both a liver bed resection and lymph node dissection. Four years later, she underwent a further resection of a port site recurrence of gallbladder cancer and no other site of recurrence was observed. The seeding of cancer cells during the removal of the resected gallbladder might have caused this tumor. This case may show that the port site recurrence did not necessarily indicate an incurable stage of the disease. In addition, an excision of the recurrent tumor also appeared to eliminate the disease in the patient.- - - - - - - - - - ranking = 1keywords = gallbladder (Clic here for more details about this article) |
8/35. Seeding from early stage gallbladder carcinoma after laparoscopic cholecystectomy.In the last years laparoscopic cholecystectomy has become the "gold standard therapy" in the treatment of symptomatic cholelitiasis, but it is necessary to keep into account some problems and risks that can arise from laparoscopic technique. One of these risks is represented surely by the disregarding of a gallbladder carcinoma. The authors report a case of peritoneal seeding of an unsuspected gallbladder carcinoma following laparoscopic cholecystectomy. The first histologic diagnosis was chronic ulcerous cholecystitis with adenomiosis but 2 months later the metastasis developed at the umbilical port site, at another port site and to the right lobe of the liver. Another histological sampling of the gallbladder specimen was performed and this time a little intra mucous gallbladder adenocarcinoma was found (T1 stage). While the most part of literature data concern advanced stage of the disease at the time of operation (T2, T3) only few reports regard early stage neoplasm. Therefore this risk is present not only in advanced stages of gallbladder carcinoma but even in cases of early stage cancers. After a laparoscopic cholecystectomy all specimen should be opened and inspected. If there is a gallbladder wall irregularity and if there was a bile spillage it is advisable to perform a preoperative histologic examination.- - - - - - - - - - ranking = 1.4285714285714keywords = gallbladder (Clic here for more details about this article) |
9/35. Unexpected bile duct carcinoma presenting with port-site metastasis after laparoscopic cholecystectomy for cholecystolithiasis.On March 1, 1999, a 71-year-old woman was diagnosed as having cholecystolithiasis, for which she underwent laparoscopic cholecystectomy at a local hospital. Intraoperative cholangiography was not performed. No malignant lesion was detected in the gallbladder. In March 2000, a subcutaneous tumor was pointed out at the port site in her abdomen, and resected. Histological examination revealed metastatic adenocarcinoma. On detailed examination, endoscopic retrograde cholangiopancreatography (ERCP) revealed a tumor, about 2 cm in diameter, in the lower bile duct. On June 1, she underwent pylorus-preserving pancreatoduodenectomy at our institute, and several disseminated lesions were detected at the port site and in the abdominal cavity. There have been few reports of bile duct carcinoma that developed peritoneal dissemination caused by leakage of bile during cholecystectomy. Leakage of bile should be prevented during laparoscopic cholecystectomy, even in patients not diagnosed as having cancer preoperatively.- - - - - - - - - - ranking = 0.14285714285714keywords = gallbladder (Clic here for more details about this article) |
10/35. Gallstone embedded within a port site metastasis--report of a case.The occurrence of port site metastasis after laparoscopic cholecystectomy for an incidental gallbladder carcinoma is well-documented but the underlying aetiology is not clear. Several mechanisms including tumour implantation to the effects of carbon dioxide usage have been implicated. Here, we describe an unusual case of a late port site recurrence in a 60-year-old woman where a gallstone was found embedded within the heart of the recurrence. We critically review the basic and clinical evidence that contributes to the pathophysiology of this phenomenon and the surgical strategies employed.- - - - - - - - - - ranking = 0.14285714285714keywords = gallbladder (Clic here for more details about this article) |
| | Next -> |