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A Journal on Surgery
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Chirurgia 2014 February;27(1):1-4
The role of open cholecystectomy for gallbladder cancer in laparoscopic era: our experience and literature review
De Werra C., Bracciano L., Di Micco R., Aloia S., Del Giudice R., Cervotti M., Galloro G., Bucci L.
Department of General, Geriatric Oncologic Surgery and Advanced Technologies University of Naples Federico II, Naples, Italy
Aim: Currently, cholecystectomy can be performed using three techniques: open, laparoscopic with 3-4 trocar and single incision laparoscopic (S.I.L.S.). The most widely used technique is the laparoscopic one with 4 trocar, combining excellent cosmetic results with reduced postoperative pain and short hospital stay.
Methods: We have analysed all laparoscopic cholecystectomies performed in the Department of General, Geriatric, Oncologic Surgery and Advanced Technologies of the University of Naples, from March 2003 to June 2012. Our interest focused on open cholecystecomy performed as a conversion in cases of incidental diagnosis of GBC or “of principle” after preoperative suspicion. The first patient was a 81 year-old woman, whose definitive anatomopathological examination revealed only an adenomyoma of the gallbladder and gallstones. She’s currently alive and she’s 89 years old. The second patient was a 58-year-old man, whose definitive anatomopathological examination revealed no malignant disease, but only cholesterolosis in the bottom of tha gallbladder. The third patient was a recent case of suspected GBC after preoperative USG, that we treated by open access even if in laparoscopic era.
Results: We have reported three cases of suspicion not confirmed by definitive diagnosis, thus underlying the importance of some concepts.
Conclusion: The GBC is a too aggressive kind of cancer to enjoy the freedom of ignoring guidelines or to be optimistic in cases of suspicion. As regards the cosmetic result maybe a greater scare is less important than greater risk, if you consider the possible spreading of cancer cells during VLC in a mistaken GBC.