Sarli L, Costi R, Pietra N, Gobbi S
Institute of General Surgery and Surgical Therapy, Parma University School of Medicine, Italy.
Surg Laparosc Endosc Percutan Tech. 1999 Dec;9(6):414-7.
Early peritoneal seeding and trocar site metastasis from gallbladder cancer have been reported after laparoscopic cholecystectomy. Nevertheless, the role of laparoscopy in gallbladder cancer remains controversial. Two cases of early recurrence of carcinoma of the gallbladder after laparoscopic cholecystectomy are described. In the first case, the use of a gasless technique did not prevent an early, diffuse peritoneal dissemination of the disease. In the second case, despite the use of a retrieval bag to extract the gallbladder, multiple metastases around the gallbladder bed and local peritoneal seeding developed. These cases demonstrate that factors other than bile spillage, CO2 inflation, and the use of a retrieval bag are responsible for early dissemination of gallbladder cancer.
据报道,腹腔镜胆囊切除术后可出现胆囊癌早期腹膜种植和套管针穿刺部位转移。然而,腹腔镜在胆囊癌治疗中的作用仍存在争议。本文描述了2例腹腔镜胆囊切除术后胆囊癌早期复发的病例。第一例中,使用免气腹技术未能防止疾病早期弥漫性腹膜播散。第二例中,尽管使用了取物袋取出胆囊,但胆囊床周围出现多处转移及局部腹膜种植。这些病例表明,除胆汁外溢、二氧化碳气腹和使用取物袋外,其他因素也可导致胆囊癌早期播散。