title: Simultaneous laparoscopic treatment for diseases of the gallbladder, stomach, and colon.
abstract: We describe a successful simultaneous laparoscopic treatment of a gallstone and gastric and colonic neoplasms. The patient was a 72-year-old man with epigastric discomfort. Abdominal ultrasound revealed a gallstone 2 cm in diameter. Gastroscopy revealed a 3-cm protruding submucosal tumor in the gastric fundus and colonoscopy revealed a 2-cm sessile lesion in the sigmoid colon. He underwent simultaneous laparoscopic treatment of the 3 organs because of the high risk of perforation or bleeding after gastric or colonic resection. This required the use of 5 ports, and a 3.5-cm incision was made in the left lower quadrant to access the 3 organs. The laparoscopic procedures consisted of cholecystectomy, partial stapled resection of the gastric fundus, and partial resection of the sigmoid colon. The histopathologic diagnoses were chronic cholecystitis, leiomyoma of the stomach, and tubulovillous adenoma with severe dysplasia of the colon. The operation took 183 minutes and blood loss was minimal. The patient started oral intake from the second postoperative day and was discharged uneventfully. He had from no postoperative complications or abdominal symptoms during a 15-month follow-up period. To our knowledge, this is a first successful clinical report of simultaneous laparoscopic treatment of 3 organ disorders.
authors.affiliation: Second Department of Surgery, Dokkyo University School of Medicine, Mibu, Tochigi, Japan. tagaya@dokkyomed.ac.jp
authors.forename: Nobumi
authors.initials: N
authors.lastname: Tagaya
authors.forename: Kazunori
authors.initials: K
authors.lastname: Kasama
authors.forename: Norio
authors.initials: N
authors.lastname: Suzuki
authors.forename: Shoujirou
authors.initials: S
authors.lastname: Taketsuka
authors.forename: Kenji
authors.initials: K
authors.lastname: Horie
authors.forename: Keiichi
authors.initials: K
authors.lastname: Kubota
mesh_terms: D018253:Adenoma, Villous / Q000453:epidemiology / Q000601:surgery*; D000368:Aged; D017081:Cholecystectomy, Laparoscopic; D041761:Cholecystolithiasis / Q000453:epidemiology* / Q000601:surgery*; D003110:Colonic Neoplasms / Q000453:epidemiology / Q000601:surgery*; D015897:Comorbidity; D006801:Humans; D010535:Laparoscopy; D007889:Leiomyoma / Q000453:epidemiology / Q000601:surgery*; D008297:Male; D013274:Stomach Neoplasms / Q000453:epidemiology / Q000601:surgery*