title: Missed malignancies during laparoscopic cholecystectomy.
abstract: OBJECTIVE
  Laparoscopic cholecystectomy is now the treatment of choice for symptomatic gallstone diseases. However, besides its great benefits, perhaps the most disappointing complication of this operation is missed malignancies. In this study, patients who had missed malignancies that were diagnosed shortly after laparoscopic cholecystectomy were studied. We aim to find out the cause of missed and delayed diagnosis.
  
  
  METHODS
  Between 1991 and June 1997, 9 patients undergoing laparoscopic cholecystectomy, which had been performed elsewhere 2-9 months earlier, and having had missed malignancy were included in this study. A diagnostic survey was collected from the medical records, questionnaires, and a semiological analysis. All laboratory data and physical findings, before and after laparoscopic cholecystectomy, were recorded. Follow-up data were obtained through a telephone questionnaire.
  
  
  RESULTS
  Of these 9 patients, 6 had colorectal carcinoma and 3 had pancreas carcinoma. All patients complained of recent atypical pain at the time of laparoscopic cholecystectomy, except for 1 patient who had no symptomatic regression.
  
  
  CONCLUSIONS
  It is necessary to make a careful semiological, physical and laboratory analysis of patients with cholelithiasis before especially laparoscopic cholecystectomy. Elderly patients, atypical biliary pain and associated symptoms must draw attention to the possibility malignancy.
authors.affiliation: Hacettepe University Faculty of Medicine, Department of General Surgery, Ankara, Turkey.
authors.forename: E
authors.initials: E
authors.lastname: Hamaloglu
authors.forename: K
authors.initials: K
authors.lastname: Yorganci
authors.forename: Z
authors.initials: Z
authors.lastname: Oner
authors.forename: I
authors.initials: I
authors.lastname: Sayek
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D000368:Aged; D017081:Cholecystectomy, Laparoscopic; D002769:Cholelithiasis / Q000150:complications* / Q000601:surgery*; D003082:Colectomy; D015179:Colorectal Neoplasms / Q000150:complications* / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010190:Pancreatic Neoplasms / Q000150:complications* / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery