Raznatović Zoran J, Zarić Nemanja D, Galun Danijel A, Lekić Nebojsa S, Micev Marjan, Djordjevic Vladimir R, Djurasic Ljubomir M, Kerkez Mirko D
The Faculty of medicine, University of Belgrade, Serbia.
Acta Chir Iugosl. 2012;59(1):105-9. doi: 10.2298/aci1201105r.
Laparoscopic cholecystectomy is a surgical procedure of choice for benign gallbladder diseases. In about 1-2% of cases histopathological examination demonstrate incidental gallbladder cancer (GBCA). We report a case of a 61 year old woman who developed port site metastases after laparoscopic cholecystectomy for adenocarcinoma of the gallbladder. Metastases appeared on all four port sites. Review of literature regarding incidental GBCA an port site metastases was also performed. We conclude that the retrieval bag should be routinely used in laparoscopic cholecystectomy; the procedure should be performed with minimal trauma; in cases of incidental GB carcinoma, full thickness excision of the abdominal wall of the port sites demands additional studies; additional liver bed excision and local lymphadenectomy for T1b carcinoma are yet to be considered.
腹腔镜胆囊切除术是治疗良性胆囊疾病的首选外科手术。在约1%-2%的病例中，组织病理学检查显示意外胆囊癌（GBCA）。我们报告一例61岁女性，她在因胆囊腺癌接受腹腔镜胆囊切除术后发生了穿刺孔转移。转移出现在所有四个穿刺孔部位。我们还对有关意外GBCA和穿刺孔转移的文献进行了回顾。我们得出结论，在腹腔镜胆囊切除术中应常规使用取物袋；手术应尽量减少创伤；对于意外胆囊癌病例，穿刺孔部位腹壁的全层切除需要进一步研究；对于T1b期癌，是否需要额外的肝床切除和局部淋巴结清扫仍有待考虑。
