[Treatment of unexpected gallbladder carcinoma after laparoscopic cholecystectomy]
Zhiyan Wang1, Xiao Liang1, Shilin He1
1Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, China.
Objective:
To summarize the clinical features and diagnostic and therapeutic experiences of unexpected gallbladder carcinoma (UGC) during or after laparoscopic cholecystectomy (LC) to boost radical resection rate and long-term efficacy.
Methods:
The clinical data of 64 UGC patients undergoing LC were retrospectively analyzed.
Results:
The procedures included LC (n = 28) and LC plus radical resection (n = 36). The follow-up period was 2-132 months. The inter-group differences were statistically significant in post-operative survival rate (35 vs 46 months, P < 0.05). According to the TNM staging system, the post-operative survival rate between two groups for pTis+pT1a grade was not statistically significant (84 vs 132 months, P > 0.05).However the differences for pT1b, pT2 and pT3 grades were statistically significant (43 vs 86 months; 31 vs 52 months; 18 vs 36 months, P < 0.05).
Conclusions:
Identification of high-risk factors and intraoperative rapid pathologic examination improve radical resection rate.Radical cure via LC may be achieved for pTis and pT1a stages of UGC.For pT1b stage of UGC, optimal surgical procedures need further explorations.For stages pT2 and pT3 of UGC, radical surgery should be added for improved long-term efficacies.