[Intraabdominal malignant pathology missed at laparoscopic cholecystectomy]

Due to its overwhelming benefits, laparoscopic cholecystectomy represents the "gold standard" for the treatment of symptomatic gallbladder stones. Allowing us to quickly solve an easy to diagnose pathology (by ultrasonography), in some cases it may lead us to mis-diagnose some major intraabdominal pathology, perhaps by a superficial interpretation of our clinical examination and para-clinic investigation data. Studying the archives of our clinic from January 1995 up to December 2003, we found 15 cases of intraabdominal neoplasia diagnosed in the year that followed laparoscopic cholecystectomy: 7 colorectal cancers, 4 pancreatic cancers, 2 gastric carcinomas, one uterine and one adrenocortical malignancies. Among these, 6 cases were in an advanced stage--because of local invasion or distant metastases--without the possibility of radical, curative surgery. Only 4 of the 15 cholecystectomies were performed for acute cholecystitis. The average age was 56.3 years, under the age when such malignancies have the maximum incidence.