title: Preneoplastic and neoplastic gallbladder lesions occasionally discovered after elective videocholecystectomy for benign disease. A single centre experience and literature review.
abstract: BACKGROUND
  In this study we retrospectively reviewed data on 311 consecutive elective cholecystectomies, performed for benign disease (cholelithiasis, cholecystitis) in our institution in the last six years, in order to determine the frequency of unexpected gallbladder pre-neoplastic and neoplastic lesions and analyse their clinical, diagnostic and therapeutic features.
  
  
  METHODS
  Three hundred eleven consecutive patients underwent elective cholecystectomy for benign gallbladder disease in our Institution from January 2005 to March 2011. Clinical records and histo-pathological reports were reviewed in order to detect occult gallbladder pre-neoplastic and neoplastic lesions and describe the clinical, diagnostic and therapeutic findings. Eight patients were excluded for lacking of important clinical data.
  
  
  RESULTS
  Out of 303 patients examined, 26 (8.6%) were found to be affected by a concomitant pre-neoplastic or neoplastic lesion. Ten (3.3%) were found to have a benign lesion, 13 (4.3%) a dysplasia of the gallbladder epithelium and 3 (1%) a gallbladder adenocarcinoma.
  
  
  CONCLUSIONS
  Dysplasia was found in 4,3% of cases and surgery represents the interruption of an eventual malignant evolution. Adenomiomatosis and adenomas represent the most frequent benign occult lesions discovered; surgery is the definitive cure for such lesions. Occult gallbladder adenocarcinoma was detected in 1% of cases in absence of any preoperative clinical or radiological suspect. Cholecystectomy is curative in stage T1a disease, while a re-resection is necessary for more invasive non metastatic disease.
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Paliogiannis
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Scognamillo
authors.forename: Federico
authors.initials: F
authors.lastname: Attene
authors.forename: Antonio
authors.initials: A
authors.lastname: Marrosu
authors.forename: Emilio
authors.initials: E
authors.lastname: Trignano
authors.forename: Laura
authors.initials: L
authors.lastname: Tedde
authors.forename: Daniele
authors.initials: D
authors.lastname: Delogu
authors.forename: Mario
authors.initials: M
authors.lastname: Trignano
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002763:Cholecystectomy / Q000379:methods; D002764:Cholecystitis / Q000601:surgery*; D002769:Cholelithiasis / Q000601:surgery*; D017558:Elective Surgical Procedures; D005260:Female; D005706:Gallbladder Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D006801:Humans; D033162:Incidental Findings; D008297:Male; D008875:Middle Aged; D011230:Precancerous Conditions / Q000175:diagnosis* / Q000453:epidemiology; D012189:Retrospective Studies; D020535:Video-Assisted Surgery; D055815:Young Adult