title: Incidental gallbladder cancer after cholecystectomy: 1990 to 2014.
abstract: BACKGROUND
  Cancer of the gallbladder is a serious diagnostic and therapeutic problem. According to the literature, 30% of cases are not confirmed before surgery. Other cases are detected incidentally by histopathology. Clinical trials and meta-analyses show that incidental gallbladder cancer (iGBC) occurs in 0.19%-2.8% of patients after cholecystectomy. The aim of this study was to analyze the incidence and severity of iGBC in cholecystectomy procedures performed in the surgical department at the 4th Military Teaching Hospital in Wroclaw during the years 1990-2014.
  
  
  METHODS
  In the years 1990-2014, a total of 7,314 cholecystectomies were performed in the surgical department because of cholecystolithiasis: 6,145 were performed using the laparoscopic approach (84.02%), 867 were performed as open surgery (11.8%), and 302 cases required conversion (5.1%). In this group, 5,214 of the patients were females (71.3%) and 2,100 were males (28.7%), with an average age of 54.7 years.
  
  
  RESULTS
  We found 64 iGBC cases which were confirmed by histopathology. This represented 0.87% of all cases. In this group, 50 patients were females (78.1%) and 14 were males (21.8%), with an average age of 67.1 years. Of this group, 40 patients underwent a classic cholecystectomy, while 24 underwent laparoscopic procedures, out of which 13 cases ultimately required traditional surgery. The histopathology showed 15 carcinomas that were classified as G1 (23.4%), 28 were G2 (43.75%), and 21 were G3 (32.8%).
  
  
  CONCLUSIONS
  iGBC detected after a cholecystectomy due to cholecystolithiasis is a rare disease. We found iGBC in 0.87% of cases, which is on a comparable scale to the world literature. In the case of cancer, we frequently found it necessary to convert to an open surgical procedure. This cancer is more common in females and in people over 60 years of age.
authors.affiliation: Department of Surgery, 4th Military Teaching Hospital; Department of Clinical Basics of Physiotherapy, Faculty of Health Science.
authors.forename: Tadeusz
authors.initials: T
authors.lastname: Dorobisz
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery.
authors.forename: Karolina
authors.initials: K
authors.lastname: Dorobisz
authors.affiliation: Department of Surgery, 4th Military Teaching Hospital; Department of Surgical Specialties.
authors.forename: Mariusz
authors.initials: M
authors.lastname: Chabowski
authors.affiliation: Department of Surgery, 4th Military Teaching Hospital.
authors.forename: Wiktor
authors.initials: W
authors.lastname: Pawłowski
authors.affiliation: Department of Palliative Care Nursing, Faculty of Health Science, Wroclaw Medical University, Wroclaw, Poland.
authors.forename: Dawid
authors.initials: D
authors.lastname: Janczak
authors.affiliation: Department of Surgery, 4th Military Teaching Hospital; Department of Clinical Basics of Physiotherapy, Faculty of Health Science.
authors.forename: Dariusz
authors.initials: D
authors.lastname: Patrzałek
authors.affiliation: Department of Surgery, 4th Military Teaching Hospital; Department of Surgical Specialties.
authors.forename: Dariusz
authors.initials: D
authors.lastname: Janczak
keywords: cholecystectomy; cholecystolithiasis; incidental cancer of the gallbladder; laparoscopic cholecystectomy; radicality