A case of laparoscopic cholecystectomy for incidental carcinoma of the gallbladder with portal recurrence 5 years after the operation

Abstract

The patient was an 88–year–old man undergone laparoscopic cholecystectomy with a diagnosis of polyp of the gallbladder at another hospital. Despite the definite diagnosis of gallbladder carcinoma made after the operation, he had been followed without undergoing additional resection. Abdominal CT scan performed 4 years 8 months after the operation disclosed a 4 × 5cm tumor on the right side of the navel. The patient had been followed until 5 years one month had elapsed after the operation, when he was first seen at our hospital for second opinion. Abdominal CT scan disclosed an enlargement of the tumor to 8 × 8cm in size and the cytodiagnosis was adenocarcinoma. Thus portal recurrence of gallbladder carcinoma was suggested. Since the lesion was localized, surgery was employed. The greater omentum, peritoneum, rectus abdominis muscle, and skin as well as the tumor were resected, and the abdominal wall was reconstructed by using composition mesh. Histopathological study identified recurrence of gallbladder carcinoma. The patient has been free from recurrence, as of one year 11 months after the second operation.
Portal recurrence of gallbladder carcinoma generally carries poor prognosis, but the resection can bring about favorable prognosis if more than one year have elapsed after the initial operation and if the recurred lesion is localized.