A clinicopathological study of unsuspected gallbladder carcinomas diagnosed after laparoscopic cholecystectomy

Abstract

Purpose : This study was designed to examine clinicopathological findings of cases of unsuspected gallbladder cancer diagnosed after laparoscopic cholecystectomy (LC).
Subjects : Out of a series of 1665 cases performed LC with preoperative diagnosis of benign disease from 1992 to 2004, 12 (0.72%) cases of unsuspected gallbladder cancer diagnosed after LC were compared with 15 (0.61%) cases of gallbladder cancer diagnosed after open cholecystectomy (OC) out of 2463 OC cases.
Results : In the 12 cases after LC, the tumor was within the mucosa (m) in 6 cases, the tumor invaded the muscle layer (mp) in 1 case, and invaded the subserosal layer but did not extend beyond the serosa (ss) in 5 cases. There were no significant differences in histopathological findings between LC and OC cases. After LC, an additional operation was done in the case of mp cancer of which stump of the cystic duct was positive for tumor cells, and in 4 out of 5 cases of ss cancer. One case of ss cancer after LC terminated fatally due to another cancer and two cases of ss cancer after OC terminated fatally due to the gallbladder cancer.
Conclusions : LC might be appropriate for cases of m cancer because no recurrence was seen in those cases without re-resection. On the other hand, the cases of ss cancer after LC showed a favorable outcome by re-resection.