title: Incidental gall bladder carcinoma: does the surgical approach influence the outcome?
abstract: BACKGROUND
  The aim of the study was to evaluate the outcome in patients with unsuspected gall bladder carcinoma diagnosed after cholecystectomy, comparing the laparoscopic approach with open surgery.
  
  
  METHODS
  A retrospective study was done of 16 patients who were diagnosed with unsuspected gall bladder carcinoma out of the 2850 who had undergone cholecystectomy for symptomatic cholelithiasis at our institution between 1990 and 2004. Eight cases (seven women and one man, mean age 63 (range 49-75 years) ) were diagnosed after laparoscopic cholecystectomy (group A) and eight cases (six women and two men, mean age 63 (range 50-79 years) ) after open cholecystectomy (group B). We evaluated the outcome in the two groups correlating the cumulative survival rates with tumour stage and surgical technique.
  
  
  RESULTS
  In group A, three patients had port-site recurrence (1 pT1a and 2 pT1b tumours) after 6, 7 and 9 months, one had intraperitoneal dissemination (pT2) after 3 months, and four had no recurrence (1 pTis, 2 pT1a and 1 pT1b). In group B, five patients had recurrences (4 pT1b and 1 pT2) after an average of 8 months (range 5-11) and three had no recurrence (1 pTis and 2 pT1a). Survival rate was statistically correlated with tumour stage but not with the surgical approach used to perform cholecystectomy.
  
  
  CONCLUSIONS
  The surgical approach used for cholecystectomy would seem not to influence the outcome in patients with unsuspected gall bladder carcinoma. The tumour stage is the most important prognostic factor.
authors.affiliation: Department of Human Pathology, University of Messina, Messina, Italy.
authors.forename: Eugenio
authors.initials: E
authors.lastname: Cucinotta
authors.forename: Cesare
authors.initials: C
authors.lastname: Lorenzini
authors.forename: Giuseppinella
authors.initials: G
authors.lastname: Melita
authors.forename: Giuliano
authors.initials: G
authors.lastname: Iapichino
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Currò
mesh_terms: D000368:Aged; D002763:Cholecystectomy; D002769:Cholelithiasis / Q000601:surgery; D005260:Female; D005706:Gallbladder Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D006801:Humans; D033162:Incidental Findings; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009366:Neoplasm Seeding; D015996:Survival Rate; D016896:Treatment Outcome