title: Risk of missing colorectal cancer during laparoscopic cholecystectomy.
abstract: OBJECTIVE
  The increased number of patients undergoing laparoscopic cholecystectomy (LC) is associated with a risk of missing concomitant colorectal cancers; however, the incidence and cause have not yet been well recognized. Our aim, therefore, was to evaluate these factors.
  
  
  METHODS
  This retrospective study evaluated data on 473 patients with benign gallbladder diseases, who underwent LC between January 1991 and December 1999. Among these 473 patients, 2 (0.4%) were thought to have had detectable cancer at LC.
  
  
  RESULTS
  The first patient was a 59-year-old woman who underwent palliative resection for ascending colon cancer associated with liver and pulmonary metastases 10 months following LC when laboratory data showed a low hemoglobin level (10.0 g/dl). The other patient, a 50-year-old man, underwent resection for Dukes' C sigmoid colon cancer 6 months following LC. At LC, the patient did not present with any symptoms suggesting the existence of colorectal cancer and the laboratory data were normal.
  
  
  CONCLUSIONS
  These results indicate that although an extremely low incidence of missed colorectal cancers does not justify routine screening for colorectal cancer before LC in terms of cost-effectiveness, careful attention to preoperative physical findings and laboratory data as well as meticulous techniques and full diagnostic visualization of the large-bowel intraoperatively may reduce the potential risk of missing coexisting colorectal cancers during LC.
authors.affiliation: Department of Surgery, Saitama Medical Center, Saitama Medical School, Kawagoe, Japan.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Ishida
authors.forename: Tomonori
authors.initials: T
authors.lastname: Ohsawa
authors.forename: Nobuo
authors.initials: N
authors.lastname: Murata
authors.forename: Masashi
authors.initials: M
authors.lastname: Fujioka
authors.forename: Daijo
authors.initials: D
authors.lastname: Hashimoto
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017081:Cholecystectomy, Laparoscopic; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D005260:Female; D005705:Gallbladder Diseases / Q000150:complications / Q000601:surgery; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors