Slim K, Pezet D, Clark E, Chipponi J
Service de Chirurgie générale et digestive, Hôtel-Dieu, Clermont-Ferrand, France.
Am J Surg. 1996 Mar;171(3):364-5. doi: 10.1016/S0002-9610(97)89643-2.
Laparoscopic cholecystectomy (LC) is now the treatment of choice for gallstone disease. The wide acceptance of LC resulted in increased cholecystectomy rates and entailed specific drawbacks such as missed malignant tumors of other organs.
The prospective follow-up of patients who underwent LC was studied, and all patients treated for malignant disease were included regarding a history of LC.
Of 838 LCs performed, 5 patients underwent reoperation for missed carcinoma of the pancreas (n=2) and the right colon (n=3). Two other patients with carcinomas of the pancreas and the right colon had a history of LC performed elsewhere. All 7 patients (median age 72 years) complained of recent atypical pain at the time of the LC. Five tumors were resected (2 palliatively); 2 patients died.
This study emphasizes the necessity of making a careful semiological analysis of the pain and associated symptoms before performing an LC.
腹腔镜胆囊切除术（LC）目前是胆结石疾病的首选治疗方法。LC的广泛应用导致胆囊切除率上升，并带来了一些特定的缺点，如遗漏其他器官的恶性肿瘤。
对接受LC治疗的患者进行前瞻性随访研究，所有接受恶性疾病治疗的患者均纳入关于LC病史的研究。
在838例LC手术中，5例患者因遗漏胰腺癌（2例）和右结肠癌（3例）而接受再次手术。另外2例患有胰腺癌和右结肠癌的患者在其他地方有过LC手术史。所有7例患者（中位年龄72岁）在进行LC手术时均诉说近期有非典型疼痛。5例肿瘤被切除（2例为姑息性切除）；2例患者死亡。
本研究强调在进行LC手术前对疼痛及相关症状进行仔细的症状学分析的必要性。
