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Case Reports
. 2018 Aug 2:33:56-59.
doi: 10.1016/j.amsu.2018.07.009. eCollection 2018 Sep.

Surgical strategy for suspected early gallbladder carcinoma including incidental gallbladder carcinoma diagnosed during or after cholecystectomy

Toshikatsu Nitta  1 , Jun Kataoka  1 , Masato Ohta  1 , Kensuke Fujii  1 , Yuko Takashima  1 , Yoshihiro Inoue  1 , Takashi Ishibashi  1
Affiliations
Case Reports

Surgical strategy for suspected early gallbladder carcinoma including incidental gallbladder carcinoma diagnosed during or after cholecystectomy

Toshikatsu Nitta et al. Ann Med Surg (Lond). .

Abstract

Purpose: This paper presents an overview of the surgical strategy for patients with suspected gallbladder carcinoma (GBC), including incidental GBC cases, preoperatively or intraoperatively, as well as their outcomes.

Methods: Between April 2009 and December 2017, 529 patients underwent cholecystectomy for gallbladder disease at our hospital. Both intraoperative and postoperative histological examinations of the excised gallbladder facilitated the diagnosis of GBC. Surgery-related variables and surgical approaches were evaluated according to the extent of tumor invasion.

Results: Of 529 patients, eight were diagnosed with GBC during/after cholecystectomy, including four women and four men. Mean age was 75.4 (range, 59-89) years. Five patients had gallbladder stones and three had cholecystitis. Three patients with stages T1b and T2 underwent additional liver bed wedge resections with or without prophylactic common bile duct excision. Five of the eight patients are still alive and two of the remaining three died from other diseases; one patient with pT3 died of recurrent GBC (peritonitis carcinomatosa).

Conclusion: Because of the ability to obtain full-thickness frozen biopsies during laparoscopic cholecystectomy, we could diagnose GBC intraoperatively, allowing for rapid diagnosis and tumor resection. We recommend developing a surgical treatment strategy for suspected early GBC in advance of cholecystectomy.

Keywords: GBC; Gallbladder carcinoma; Laparoscopic cholecystectomy; Surgical strategy; Suspected early gallbladder carcinoma.

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Figures

Fig. 1
Fig. 1
Surgical strategy for suspected early gallbladder carcinoma in our hospital. This flow chart describes the surgical strategy for the intraoperative diagnosis and treatment of gallbladder carcinoma. It is important to have a surgical plan in place, so that gallbladder carcinoma can be diagnosed and treated during a single procedure.
See this image and copyright information in PMC

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