title: Long-term survival of patients with gallbladder cancer detected during or after laparoscopic cholecystectomy.
abstract: Little evidence is available regarding long-term survival of patients with gallbladder cancer that is discovered at the time of laparoscopic cholecystectomy (LC). Therefore the present study was performed to evaluate long-term outcomes of this disease. Of 1546 patients who underwent LC for benign gallbladder disease between January 1992 and January 2002, 8 patients (0.5%) had cancers that were found during or after LC. The median follow-up period was 55 months (range: 36-142 months). The gallbladder was resected without perforation in all cases. During surgery there was a suspicion of malignancy in 6 of 8 cases. Frozen section analysis showed that 2 had TNM stage Tis tumors, 2 had T1a tumors, and 2 had T2 tumors. Two patients with T2 tumors were immediately converted to extended cholecystectomy. The final pathology revealed another 2 tumors, and demonstrated that 3 patients had Tis tumors, 3 had T1a tumors, and 2 had T2N0M0 tumors. None of the patients underwent additional surgery. All patients survived with no evidence of recurrence during the median follow-up of 55 months. In conclusion, before and during LC, we have not overlooked T2 or more advanced tumor, which requires additional procedures for curative resection. This might result in good survival. We consider that an intensive preoperative work-up and meticulous inspection of the opened gallbladder should be mandatory to detect gallbladder cancer in patients who undergo LC. At present, this is not routinely practiced.
authors.affiliation: Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, 160-8582 Shinjyuku-ku, Tokyo, Japan.
authors.forename: Tomotaka
authors.initials: T
authors.lastname: Akatsu
authors.forename: Masakazu
authors.initials: M
authors.lastname: Ueda
authors.forename: Motohide
authors.initials: M
authors.lastname: Shimazu
authors.forename: Go
authors.initials: G
authors.lastname: Wakabayashi
authors.forename: Koichi
authors.initials: K
authors.lastname: Aiura
authors.forename: Minoru
authors.initials: M
authors.lastname: Tanabe
authors.forename: Shigeyuki
authors.initials: S
authors.lastname: Kawachi
authors.forename: Hiromu
authors.initials: H
authors.lastname: Kido
authors.forename: Masaki
authors.initials: M
authors.lastname: Kitajima
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017081:Cholecystectomy, Laparoscopic; D005260:Female; D005629:Frozen Sections; D005705:Gallbladder Diseases / Q000601:surgery*; D005706:Gallbladder Neoplasms / Q000175:diagnosis* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D015996:Survival Rate