Abdominal malignancies missed during laparoscopic cholecystectomy.
BACKGROUND
We present our experience with intra-abdominal malignancies different from gallbladder cancer not diagnosed preoperatively and undiscovered during laparoscopic cholecystectomy


METHODS
This study involved retrospective analysis of 10 patients hospitalized in the Second Department of General Surgery between 1993 and 2000. In all of them, laparoscopic cholecystectomy had been performed between one week and 21 months earlier.


RESULTS
Primary or metastatic neoplasms were diagnosed in five men and five women patients ages 38 to 79 years. In three patients with colorectal cancer, a radical resection was possible. Nonresectable pancreatic cancer was found in three patients. In one of two patients with gastric cancer, palliative, distal gastrectomy was performed. In a patient who had small bowel cancer with metastasis to the ovary, a radical operation was possible. In one patient, liver metastasis from lung cancer was found.


CONCLUSIONS
In patients with atypical symptoms of gallbladder lithiasis, a thorough workup before laparoscopic cholecystectomy should be performed. During the laparoscopic procedure, a detailed examination of the whole peritoneal cavity is essential. In cases of prolonged convalescence after laparoscopic cholecystectomy, a source of symptoms different from cholelithiasis should be suspected.
Wysocki
A
A
Department of General Surgery, Jagiellonian University, Collegium Medicum, ul. Kopernika 21, 31-501 Krakow, Poland.
Lejman
W
W
Bobrzynski
A
A
D000008:Abdominal Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D000368:Aged; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects / Q000379:methods*; D002769:Cholelithiasis / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D011379:Prognosis; D014481:United States / Q000453:epidemiology