Incidental gallbladder cancer: How should we do?

Abstract

Incidental gallbladder cancer is increasing with technological advances in laparoscopic cholecystectomy. The principles of resection for T1b or greater gallbladder cancer are radical cholecystectomy including gallbladder bed and lymphadenectomy and extended hepatic or biliary resection as necessary to obtain a negative margin. For incidental gallbladder cancer over T1b, therefore, additional resection is recommended. In our 3, 061 cholecystectomies on benign disease, we experienced 48 cases (1.6%) with incidental gallbladder cancer. Recurrence was observed in 19 (40%) cases. Additional resection was 11 (23%), and 3 cases suffered from recurrence. In conclusion, grately careful attention concerning with cancer is significant for preoperative diagnosis for cholecystectomy. If highly suspected gallbladder cancer, whole layer cholecystectomy is recommended to avoid spilling bile as this can result in peritoneal dissemination. Moreover, additional resection should be considered for T1b or greater cancer on postoperative pathologic review.