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Chirurgia 2001 April;14(2):89-92

Copyright © 2001 EDIZIONI MINERVA MEDICA

language: Italian

Sequential abdominal wall recurrences of incidental gallbladder cancer after laparoscopic cholecystectomy for gallstones. Case report and literature review

Valduga P., Zani B., Battocletti M., Lauro E., Marcucci S.


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Incidental gallbladder cancer occurs in about 0.3% of laparoscopic cholecystectomies, with the risk of cancer cells dissemination in about 17% of cases. We report the case of a seventy-eight- year-old woman who underwent laparoscopic cholecystectomy for gallbladder stones with chronic inflammation. She had performed two preoperative ultrasound scans of the abdomen and one ERCP but no cancer was identified. The postoperative histological examination showed a medium differentiated adenocarcinoma of the gallbladder without exceeding its wall (pT1). Not other treatments were performed. After seven months first cancer recurrence appeared in the periumbilical trocar site, and abdominal wall excision was performed. A second cancer relapse appeared after one year from cholecystectomy in two trocar sites in other abdominal quadrants, and a new abdominal wall excision was performed. At present, after two months from the last operation,
the patient is free from metastases and intra-abdominal relapses. Literature concerning prevention, therapeutical options and prognosis of incidental gallbladder cancer during laparoscopic cholecystectomy is briefly reviewed. Laparoscopic procedure does not worsen any long-term prognosis of these patients; the problem of recurrence of undiagnosed gallbladder cancer, then, can not invalidate the laparoscopic technique in surgical treatment of gallstones.

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