Does laparoscopic cholecystectomy worsen the prognosis of unsuspected gallbladder cancer?
L Sarli1, S Contini, G Sansebastiano
1Institute of General Surgery and Surgical Therapy, Parma University, Via Gramsci 14, 43100 Parma, Italy. leosarli@ipruniv.cce.unipr.it
Background:
Several reports claim that there is a risk that laparoscopic cholecystectomy (LC) might worsen the prognosis of unsuspected gallbladder cancer.
Hypothesis:
Several factors rather than LC could influence prognosis.
Methods:
A retrospective clinicopathologic study was performed on 20 patients, 9 patients (3 men and 6 women, aged from 36 to 75 years [mean age, 62.3 years]) undergoing LC and 11 patients (2 men and 9 women, aged from 53 to 91 years [mean age, 65.3 years]) undergoing open cholecystectomy (OC), with postoperatively diagnosed gallbladder cancer. The correlation was evaluated between cumulative survival rates and the following 7 prognostic factors: age, sex, histopathological grade, pathologic stage, occurrence of bile spillage, type of cholecystectomy (LC or OC), and additional surgical treatments.
Results:
Seven patients (87%) after LC and 9 patients (82%) after OC had cancer recurrence: the difference is of no statistical significance (P =.9). There were no recurrences of cancer in the abdominal wall after either LC or OC. Survival rate was statistically correlated to tumor stage (P =.007) and to the occurrence of bile spillage (P =.002). Survival rate did not change according to whether the operation was carried out using LC or OC (P =.60).
Conclusion:
These results would seem to lend support to the opinion that LC does not worsen the prognosis for unsuspected gallbladder cancer.
