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KMID : 0978820030060010001
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Journal of the Korean Society of Endoscopic & Laparoscopic Surgeons
2003 Volume.6 No. 1 p.1 ~ p.7
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Is Laparoscopic Cholecystectomy for Treatment of Early Gallbladder Cancer Justified?
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Kwak Dong-Min
Lee Dong-Shik
Yun Sung-Soo
Kim Hong-Jin
Kwun Koing-Bo
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Abstract
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Purpose: With the increase of laparoscopic cholecystectomies (LC), the diagnosis of unexpected early gallbladder cancer (GBC) became more frequent. But many of these cases are incidentally identified on postoperative pathologic reviews of the specimen. The objective of the present study was to discuss the justification of LC for early GBC and necessity of an additional radical operation.
Methods: Between January 1991 and February 2001, 13 patients were identified as early GBC after LC at the department of surgery, YeungNam University medical center. We analyzed these patients retrospectively.
Results: Of these 13 patients, T-stage classification included 4 patients of stage T1a. 2 patients of T1b and 7 patients of T2 GBC on pathologic report. All patients with T1a are survived. The 1 of 2 patients wih T1b died from multiple liver metastasis after 10 months of initial LC. The 5 of 7 patients with T2 did not undergo and additional radical operation. Of these 1 of 5 patients with T2 died from local recurrence with hepatic failure after 11 months of initial LC. The 2 of 7 patients with T2 underwent an additional radical resection. Of these 2 patients with T2 in radical resection are survivng for 4 months and 43 months, respectively. But the 1 patient of radical resection following LC have a carcinomatosis after 4 months of radical resection. Most pattern of recurrence were not port-site recurrence but multiple liver metastasis and local recurrence.
Conclusion: Laparoscopic procedure should be performed by careful manipulation for reducing potential risk of bile spillage and micro perforation. And T1b and T2 GBC should be treated by additional radical operation.
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KEYWORD
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Laparoscopic cholecystectomy, Early gallbladder cancer
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