Wu Xin, Li Binglu, Zheng Chaoji, Liu Wei, Hong Tao, He Xiaodong
Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Asia Pac J Clin Oncol. 2020 Jun;16(3):158-164. doi: 10.1111/ajco.13308. Epub 2020 Feb 7.
Although incidental gallbladder cancer (IGBC) diagnosed after laparoscopic cholecystectomy (LC) is not rare, its incidence, management, and prognosis are still unclear and controversial. The present study aimed to increase the understanding of IGBC after LC in the medical community.
Patients with IGBC treated at our institution between January 2001 and December 2018 were enrolled. Data collected included demographic characteristics, treatment pattern, pathological information, and prognoses. We compared the characteristics of patients with different prognoses and calculated the cumulative overall survival rate and mean survival period for IGBC.
The cohort comprised 26 patients with a mean age of 66.4 ± 12.5 years. All patients were diagnosed with IGBC via postoperative pathology. Three patients underwent radical reoperation. As of June 2019, 26 patients were followed for a mean of 31.6 ± 29.6 months. Fourteen patients died during the follow-up period, and 12 survived without recurrence. The mean survival duration was 50.5 months. The 1-, 3-, and 5-year cumulative overall survival rates of the entire cohort were 79.8, 49.0, and 40.8%, respectively. IGBC patients with T1a stage had significantly longer survival than those with T1b or more advanced stages (96.1 vs 32.6 months, P = .006).
IGBC after LC is diagnosed in 0.2% of patients, accounting for 5.4% of all gallbladder cancer cases. IGBC patients with T1a stage had significantly longer survival than those with T1b or more advanced stages. Simple cholecystectomy is probably acceptable only in T1a lesions.
尽管腹腔镜胆囊切除术（LC）后诊断出的意外胆囊癌（IGBC）并不罕见，但其发病率、治疗方法和预后仍不明确且存在争议。本研究旨在提高医学界对LC术后IGBC的认识。
纳入2001年1月至2018年12月在我院接受治疗的IGBC患者。收集的数据包括人口统计学特征、治疗方式、病理信息和预后。我们比较了不同预后患者的特征，并计算了IGBC的累积总生存率和平均生存期。
该队列包括26例患者，平均年龄为66.4±12.5岁。所有患者均通过术后病理诊断为IGBC。3例患者接受了根治性再次手术。截至2019年6月，26例患者平均随访31.6±29.6个月。14例患者在随访期间死亡，12例存活且无复发。平均生存时间为50.5个月。整个队列的1年、3年和5年累积总生存率分别为79.8%、49.0%和40.8%。T1a期IGBC患者的生存期明显长于T1b期或更晚期患者（96.1个月对32.6个月，P = 0.006）。
LC术后IGBC在0.2%的患者中被诊断出，占所有胆囊癌病例的5.4%。T1a期IGBC患者的生存期明显长于T1b期或更晚期患者。单纯胆囊切除术可能仅适用于T1a期病变。
