Kwon A-Hon, Imamura Atsushi, Kitade Hiroaki, Kamiyama Yasuo
Department of Surgery, Kansai Medical University, Osaka, Japan.
J Surg Oncol. 2008 Mar 1;97(3):241-5. doi: 10.1002/jso.20944.
The long-term prognosis of laparoscopic cholecystectomy (LC) for patients with unsuspected gallbladder carcinoma (GBC) remains unclear. We investigated retrospectively the role of examination of frozen sections and the prognosis of patients with unsuspected GBC detected during or after LC.
LC was performed on 1,793 consecutive patients. If a suspicious lesion was found, intraoperative frozen section examination was performed.
Of all these patients, 38 (2.1%) were histopathologically diagnosed as having a GBC during (28) or after LC (10). The tumor stages of the 28 diagnosed during LC were: pT1a (17), pT1b (2), pT2 (8), and pT3 (1). The sensitivity and specificity of intraoperative frozen section examination were 90 and 100%, respectively. On the other hand, those 10 cases diagnosed after LC had pT1a (1) and pT2 (9) tumors. Survival rates were not significantly affected by whether the patient was diagnosed with GBC during or after LC.
The survival with unsuspected GBC was related to stage and it was confirmed that a carefully performed LC is adequate treatment for Stage 1A and B cancer. The LC procedure does not adversely affect the prognosis of unsuspected GBC, regardless of whether it is detected during or after LC.
对于未被怀疑患有胆囊癌（GBC）的患者，腹腔镜胆囊切除术（LC）的长期预后仍不明确。我们回顾性研究了冰冻切片检查的作用以及在LC期间或之后发现的未被怀疑患有GBC的患者的预后。
对1793例连续患者进行了LC。如果发现可疑病变，则进行术中冰冻切片检查。
在所有这些患者中，38例（2.1%）在LC期间（28例）或之后（10例）经组织病理学诊断为患有GBC。LC期间诊断出的28例患者的肿瘤分期为：pT1a（17例）、pT1b（2例）、pT2（8例）和pT3（1例）。术中冰冻切片检查的敏感性和特异性分别为90%和100%。另一方面，LC后诊断出的10例患者患有pT1a（1例）和pT2（9例）肿瘤。患者在LC期间或之后被诊断为GBC对生存率没有显著影响。
未被怀疑患有GBC的患者的生存与分期有关，并且证实对于1A期和B期癌症，仔细实施的LC是充分的治疗方法。无论在LC期间还是之后检测到未被怀疑患有GBC，LC手术都不会对其预后产生不利影响。
