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Laparoscopic cancer surgery

Lessons from gallbladder cancer

Abstract

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.

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References

  1. 1.

    Andrus CH, Kaminski DL (1986) Segmental hepatic resection utilizing the ultrasonic dissector. Arch Surg 121: 515–521

  2. 2.

    de Aretxabala X, Roa I, Burgos L, Araya JC, Fonseca L, Wistuba I, Flores P (1992) Gallbladder cancer in Chile. Cancer 69(1): 60–65

  3. 3.

    Barsoum GH, Windsor CW (1992) Parietal seeding of carcinoma of the gallbladder. Br J Surg 79: 846

  4. 4.

    Baserga R (1981) The cell cycle. N Engl J Med 304: 453–459

  5. 5.

    Baserga R (1983) The basic biology of tumor growth. Res Staff Phys March: 41–46

  6. 6.

    Burdette WJ (1957) Cancer of the gallbladder. Ann Surg 145: 832–837

  7. 7.

    Clair DG, Lautz DB, Brooks DC (1993) Rapid development of umbilical metastases after laparoscopic cholecystectomy for unsuspected gallbladder carcinoma. Surgery 113: 355–358

  8. 8.

    Dobronte Z, Wittmann T, Karacsony G (1978) Rapid development of malignant metastases in the abdominal wall after laparoscopy. Endoscopy 10: 127–30

  9. 9.

    Donohue JH, Nagorney DM, Grant CS, Tsushima K, Ilstrup DM, Adson MA (1990) Carcinoma of the gallbladder. Arch Surg 125: 237–241

  10. 10.

    Drouard F, Delamarre J, Capron JP (1991) Cutaneous seeding of gallbladder cancer after laparoscopic cholecystectomy. N Engl J Med 325: 1316

  11. 11.

    Dubois F, Icard P, Berthelot G, Levard H (1990) Celiscopic cholecystectomy: preliminary report of thirty-six cases. Ann Surg 211: 60–62

  12. 12.

    Gournish AL, Averbach D, Schwartz MR (1991) Carcinoma of the gallbladder found during laparoscopic cholecystectomy: a case report and review of the literature. J Laparoendosc Surg 1: 361–367

  13. 13.

    Kimura W, Nagai H, Kuroda A, Morioka Y (1989) Clinicopathologic study of asymptomatic gallbladder cancer found at autopsy. Cancer 64: 98–103

  14. 14.

    Ouchi K, Owada Y, Matsuno S, Sato T (1987) Prognostic factors in the surgical management of gallbladder carcinoma. Surgery 101: 731–737

  15. 15.

    Pezet D, Fondriner E, Rotman N (1992) Parietal seeding of carcinoma of the gallbladder after laparoscopic cholecystectomy. Br J Surg 79: 230

  16. 16.

    Shira T, Buto T, Yoshida K, Kawaguchi H, Watanabe H, Kishima H (1986) Surgical pathology of polypoid lesions of the gallbladder with special reference to their classification and microscopic features. J Clin Surg 41: 17–23

  17. 17.

    Shirai Y, Yoshida K, Tsukada K, Muto T (1992) Inapparent carcinoma of the gallbladder. Ann Surg 215: 326–331

  18. 18.

    Silk YN, Douglas HO, Nava HR, Driscoll DL, Tartarian G (1989) Carcinoma of the gallbladder: the Roswell Park experience. Ann Surg 210: 751–757

  19. 19.

    Stockdale AD, Pocock TJ (1985) Abdominal wall metastasis following laparoscopy: a case report. Eur J Surg Oncol 11: 373–375

  20. 20.

    Thorbjarnarsson B, Glenn F (1959) Carcinoma of the gallbladder. Cancer 12: 1009–1015

  21. 21.

    Tsai C (1990) Monoclonal antibody to human osteosarcoma: a novel M1 26,000 protein recognized by murine hybridoma TMM-2. Cancer Res 50: 152–158

  22. 22.

    Yamaguchi K, Tsuneyoshi M (1992) Subclinical gallbladder carcinoma. Am J Surg 163: 382–386

  23. 23.

    Yong HL, Sun YG, Wan Z (1992) Polypoid lesions of the gallbladder: diagnosis and indications for surgery. Br J Surg 79: 227–229

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Author information

Correspondence to T. P. Wade.

Additional information

The views expressed in this paper are those of the authors and should not be construed to reflect the official positions of either the U.S. Air Force medical department or Saint Louis University

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Wade, T.P., Comitalo, J.B., Andrus, C.H. et al. Laparoscopic cancer surgery. Surg Endosc 8, 698–701 (1994). https://doi.org/10.1007/BF00678571

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Key words

  • Laparoscopy
  • Gallbladder
  • Cancer
  • Implantation
  • Doubling time