Surgical Treatment of Incidental Gallbladder Cancer Discovered During or Following Laparoscopic Cholecystectomy

• Published in: World journal of surgery 2015-03, Vol.39 (3), p.746-752
• Main Authors: Tian, Yuan-Hu, Ji, Xu, Liu, Bo, Yang, Guang-Yun, Meng, Xiang-Fei, Xia, Hong-Tian, Wang, Jing, Huang, Zhi-Qiang, Dong, Jia-Hong
• Format: Article
• Language: English
• Subjects: Abdominal Surgery; Adenocarcinoma - secondary; Adenocarcinoma - surgery; Adult; Aged; Aged, 80 and over; Bile Spillage; Cardiac Surgery; Cholecystectomy - methods; Cholecystectomy, Laparoscopic; Conversion to Open Surgery; Female; Gallbladder Cancer; Gallbladder Carcinoma; Gallbladder Neoplasms - pathology; Gallbladder Neoplasms - surgery; General Surgery; Humans; Incidental Findings; Laparoscopic Cholecystectomy; Lymphatic Metastasis; Male; Medicine; Medicine & Public Health; Middle Aged; Neoplasm Invasiveness; Neoplasm Recurrence, Local - pathology; Neoplasm Seeding; Neoplasm Staging; Neoplasm, Residual; Original Scientific Report; Radical Resection; Reoperation; Retrospective Studies; Surgery; Survival Rate; Thoracic Surgery; Vascular Surgery
• ISSN: 0364-2313; 1432-2323
• DOI: 10.1007/s00268-014-2864-9

Background The optimal surgical management of patients with incidental gallbladder cancer (IGBC) and their long-term survival remains unclear. Objective The purpose of this study was to examine the long-term prognosis of patients with IGBC diagnosed during or after LC. Methods Between January 2002 and January 2012, a total of 7,582 consecutive patients underwent LC for presumed gallbladder benign disease in the Chinese PLA General Hospital, China. Among them, 69 patients (0.91 %) were diagnosed to have IGBC. Their medical records, imaging data, surgery records, pathological findings, and survival data were retrospectively reviewed. Results Median age was 61 years (range: 34–83). After a median follow-up period of 61 months, the 1-, 3-, and 5-year survival rates of patients were 89.9, 78.3, and 76.8 %, respectively. The 5-year survival rates of patients with T1a, T1b, T2, and T3 stages were 95.5, 93.8, 69.2, and 44.4 %, respectively. The 5-year survival rates in simple LC ( n  = 45), converted to open extended cholecystectomy ( n  = 16), and radical second resection ( n  = 8) groups were 91.1, 37.5, and 75.0 %, respectively. Local port-site tumor recurrence was identified in one patient. Prognostic factors including depth of invasion, lymph node status, vascular or neural invasion, tumor differentiation, extent of resection, bile spillage, and type of surgery were statistically significant ( p