Parietal seeding of unsuspected gallbladder carcinoma after laparoscopic cholecystectomy.
Laparoscopic cholecystectomy (VALC) represents the treatment of choice for the symptomatic gallstones. However the occurrence of an adenocarcinoma of the gallbladder results a controindication for this surgical technique. We present a case of a 52 years old woman who underwent a VALC; histology revealed a gallbladder adenocarcinoma. For this reason the patient underwent a second operation that is right hepatic trisegmentectomy. Six months later the patient presented with a parietal recurrence at the extraction site of the gallbladder. We discuss the possible mechanism responsible for carcinomatous dissemination during laparoscopic surgery and we raccommend the use of some procedures in order to limit the risk and eventually to treat a neoplastic parietal seeding. These complications suggest the problem about the utility and the future played by video assisted laparoscopic surgery in the diagnosis and treatment of intraabdominal malignancies.
Istituto Clinica Chirurgica Generale e Terapia Chirurgica, Università degli Studi di Ancona.
C
C
Marmorale
R
R
Scibé
W
W
Siquini
M
M
Massa
A
A
Brunelli
E
E
Landi
D000230:Adenocarcinoma / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects* / Q000379:methods; D002769:Cholelithiasis / Q000601:surgery*; D005260:Female; D005706:Gallbladder Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D006801:Humans; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D012086:Reoperation; D014741:Video Recording