Marmorale C, Scibé R, Siquini W, Massa M, Brunelli A, Landi E
Istituto Clinica Chirurgica Generale e Terapia Chirurgica, Università degli Studi di Ancona.
Ann Ital Chir. 1998 Sep-Oct;69(5):613-7.
Laparoscopic cholecystectomy (VALC) represents the treatment of choice for the symptomatic gallstones. However the occurrence of an adenocarcinoma of the gallbladder results a controindication for this surgical technique. We present a case of a 52 years old woman who underwent a VALC; histology revealed a gallbladder adenocarcinoma. For this reason the patient underwent a second operation that is right hepatic trisegmentectomy. Six months later the patient presented with a parietal recurrence at the extraction site of the gallbladder. We discuss the possible mechanism responsible for carcinomatous dissemination during laparoscopic surgery and we raccommend the use of some procedures in order to limit the risk and eventually to treat a neoplastic parietal seeding. These complications suggest the problem about the utility and the future played by video assisted laparoscopic surgery in the diagnosis and treatment of intraabdominal malignancies.
腹腔镜胆囊切除术（VALC）是有症状胆结石的首选治疗方法。然而，胆囊腺癌的出现是这种手术技术的禁忌证。我们报告一例52岁女性接受VALC手术的病例；组织学检查显示为胆囊腺癌。因此，患者接受了第二次手术，即右肝三段切除术。六个月后，患者在胆囊切除部位出现腹壁复发。我们讨论了腹腔镜手术期间癌播散的可能机制，并建议采用一些程序以降低风险并最终治疗肿瘤性腹壁种植。这些并发症提示了视频辅助腹腔镜手术在腹腔内恶性肿瘤诊断和治疗中的实用性及未来发展问题。
