Wade T P, Comitalo J B, Andrus C H, Goodwin M N, Kaminski D L
Department of Surgery, Saint Louis University School of Medicine, MO 63110-0250.
Surg Endosc. 1994 Jun;8(6):698-701. doi: 10.1007/BF00678571.
Laparoscopic cholecystectomy (LC) may inhibit the discovery of unsuspected gallbladder cancer, and the effect of LC on the prognosis of gallbladder cancer is unknown. We present two cases of unsuspected gallbladder cancer removed laparoscopically and report the discovery of peritoneal tumor implantation at the umbilical port site 21 days after LC. Although gallbladder carcinoma flow cytometry has been reported to be of prognostic value by Japanese investigators, this technique did not distinguish herein between an invasive adenocarcinoma and carcinoma in situ. A cellular doubling time of 56 h was calculated from one tumor. When unsuspected invasive gallbladder cancer is found after LC, laparoscopic port sites should be inspected at reoperation and, at a minimum, the port site through which the gallbladder was removed should be widely excised. This demonstration of cancer recurrence in laparoscopic port sites may limit the application of laparoscopy to elective cancer resection.
腹腔镜胆囊切除术（LC）可能会妨碍发现未被怀疑的胆囊癌，而且LC对胆囊癌预后的影响尚不清楚。我们展示了两例通过腹腔镜切除的未被怀疑的胆囊癌病例，并报告了在LC术后21天于脐部端口部位发现腹膜肿瘤种植。尽管日本研究者报告胆囊癌流式细胞术具有预后价值，但在此项研究中该技术无法区分浸润性腺癌和原位癌。从一个肿瘤计算出细胞倍增时间为56小时。当在LC术后发现未被怀疑的浸润性胆囊癌时，再次手术时应检查腹腔镜端口部位，至少应广泛切除取出胆囊的端口部位。腹腔镜端口部位出现癌症复发的这一情况可能会限制腹腔镜在选择性癌症切除中的应用。
