Malignant tumors missed at laparoscopic cholecystectomy.

BACKGROUND

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.

PATIENTS AND METHODS

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.

RESULTS

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.

CONCLUSIONS

This study emphasizes the necessity of making a careful semiological analysis of the pain and associated symptoms before performing an LC.