title: Surgical approach does not influence the outcome of incidental gallbladder carcinoma.
abstract: Several reports claim that there is a risk that laparoscopic cholecystectomy (LC) might worsen the prognosis of unsuspected gallbladder cancer. The aim of this study was to evaluate whether the surgical approach influence the outcome in patients with incidental gallbladder carcinoma.
  
  
  METHODS
  A retrospective study was done of 28 patients who were diagnosed with unsuspected gallbladder carcinoma who had undergone cholecystectomy for benign gallbladder disease at our institution between 1999 and 2007. 20 patients (4 men and 16 women, aged from 37 to 81 years) undergoing LC (group A) and 8 patients (6 men and 2 women, aged from 43 to 88 years) undergoing open cholecystectomy (OC) (group B) with incidental diagnosed GC. We evaluated the outcome in the two groups correlating the cumulative survival rates with tumor stage and surgical technique (LC or OC), time of diagnosis (after or during cholecystectomy).
  
  
  RESULTS
  nine patients (69.2 %) in group A and four patients (30.8%) in group B had recurrence. Survival rate was statistically correlated to tumor stage (P<0.0001) Survival rate was statistically correlated with tumor stage but neither with the surgical approach used to perform cholecystectomy, nor with time of diagnosis (intra- or post-operatively).
  
  
  CONCLUSIONS
  These results would seem to lend support to the opinion that LC does not worsen the prognosis for incidental GC, regardless of whether the tumor was detected during or after cholecystectomy.
authors.affiliation: Department of Gastrointestinal Surgery, Drum Tower Hospital Clinical College of Nanjing Medical University Nanjing, China ; Department of Gastrointestinal Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School Nanjing, China.
authors.forename: Wei-Jie
authors.initials: WJ
authors.lastname: Zhang
authors.affiliation: Department of Gastroenterology, Affiliated Drum Tower Hospital of Nanjing University Medical School Nanjing.
authors.forename: Gui-Fang
authors.initials: GF
authors.lastname: Xu
authors.affiliation: Department of General Surgery, 101th Hospital of People's Liberation Army Wuxi.
authors.forename: Zhi-Qiang
authors.initials: ZQ
authors.lastname: Tian
authors.affiliation: Department of General Surgery, 101th Hospital of People's Liberation Army Wuxi.
authors.forename: Guog-Zhong
authors.initials: GZ
authors.lastname: Wu
authors.affiliation: Department of Gastrointestinal Surgery, Drum Tower Hospital Clinical College of Nanjing Medical University Nanjing, China ; Department of Gastrointestinal Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School Nanjing, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Gastrointestinal Surgery, Drum Tower Hospital Clinical College of Nanjing Medical University Nanjing, China ; Department of Gastrointestinal Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School Nanjing, China.
authors.forename: Wen-Xian
authors.initials: WX
authors.lastname: Guan
keywords: Gallbladder carcinoma; laparoscopic cholecystectomy; prognostic factors; tumor stage