Unsuspected gallbladder cancer diagnosed during or after laparoscopic cholecystectomy.
BACKGROUND
The long-term prognosis of laparoscopic cholecystectomy (LC) for patients with unsuspected gallbladder carcinoma (GBC) remains unclear. We investigated retrospectively the role of examination of frozen sections and the prognosis of patients with unsuspected GBC detected during or after LC.


METHODS
LC was performed on 1,793 consecutive patients. If a suspicious lesion was found, intraoperative frozen section examination was performed.


RESULTS
Of all these patients, 38 (2.1%) were histopathologically diagnosed as having a GBC during (28) or after LC (10). The tumor stages of the 28 diagnosed during LC were: pT1a (17), pT1b (2), pT2 (8), and pT3 (1). The sensitivity and specificity of intraoperative frozen section examination were 90 and 100%, respectively. On the other hand, those 10 cases diagnosed after LC had pT1a (1) and pT2 (9) tumors. Survival rates were not significantly affected by whether the patient was diagnosed with GBC during or after LC.


CONCLUSIONS
The survival with unsuspected GBC was related to stage and it was confirmed that a carefully performed LC is adequate treatment for Stage 1A and B cancer. The LC procedure does not adversely affect the prognosis of unsuspected GBC, regardless of whether it is detected during or after LC.
Kwon
A-Hon
AH
Department of Surgery, Kansai Medical University, Osaka, Japan. kon@takii.kmu.ac.jp
Imamura
Atsushi
A
Kitade
Hiroaki
H
Kamiyama
Yasuo
Y
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery*; D017081:Cholecystectomy, Laparoscopic; D005260:Female; D005500:Follow-Up Studies; D005629:Frozen Sections; D005706:Gallbladder Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery*; D006801:Humans; D033162:Incidental Findings; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate