Antonakis P, Alexakis N, Mylonaki D, Leandros E, M Konstadoulakis M, Zografos G, Androulakis G
First Department of Propaedeutic Surgery, University of Athens, Hippokration Hospital, Q. Sophia 114, 11527, Athens, Greece.
Eur J Surg Oncol. 2003 May;29(4):358-60. doi: 10.1053/ejso.2002.1402.
Carcinoma of the gallbladder is a rare neoplasm with a dismal prognosis. With the increase of cholecystectomies due to the wide acceptance of laparoscopic cholecystectomy, the incidental diagnosis of gallbladder carcinoma is more frequent. We report our experience with gallbladder cancer diagnosed during or after the performance of laparoscopic cholecystectomy.
We evaluated 11 patients with gallbladder cancer out of 5539 patients who underwent laparoscopic cholecystectomy. Patient clinical and demographic characteristics were reviewed.
Intraoperatively in 297 patients there was the suspicion of adenocarcinoma and frozen sections were performed. In four of them the diagnosis of adenocarcinoma was confirmed. In two of them the procedure was converted to open with gallbladder liver bed resection and regional lymph node dissection while the other two were considered inoperable. Of the remaining 5242 patients, seven were diagnosed postoperatively at the pathologic examination. Of these, five patients refused to undergo a repeat operation. We did not observe port site metastasis in any of our patients. Survival was low and ranged from 3-14 months.
Gallbladder cancer runs a short course, with a poor prognosis. The use of a meticulous laparoscopic technique seems to be important for the diagnosis and the avoidance of early complications of the disease.
胆囊癌是一种罕见的肿瘤，预后不佳。随着腹腔镜胆囊切除术被广泛接受，胆囊切除术的数量增加，胆囊癌的偶然诊断更为常见。我们报告了在腹腔镜胆囊切除术期间或之后诊断出胆囊癌的经验。
我们在5539例行腹腔镜胆囊切除术的患者中评估了11例胆囊癌患者。回顾了患者的临床和人口统计学特征。
术中怀疑297例患者患有腺癌并进行了冰冻切片检查。其中4例确诊为腺癌。其中2例手术转为开腹，行胆囊肝床切除术和区域淋巴结清扫术，另外2例被认为无法手术。在其余5242例患者中，7例在术后病理检查时被诊断出来。其中，5例患者拒绝再次手术。我们的任何患者均未观察到切口部位转移。生存率很低，为3至14个月。
胆囊癌病程短，预后差。使用精细的腹腔镜技术似乎对该病的诊断和避免早期并发症很重要。
