geoscience.net logo
+ Resolve Article
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter

+ Translate
+ Subscribe to Site Feed
GeoScience Most Shared ContentMost Shared Content

How to proceed in patients with carcinoma detected after laparoscopic cholecystectomy


, : How to proceed in patients with carcinoma detected after laparoscopic cholecystectomy. Langenbeck's Archives of Surgery 385(8): 495-500, December

Carcinoma of the gallbladder is a rare disease. Gallbladder carcinoma is detected in less than 1% of all gallstone operations. With the introduction of laparoscopic surgery and the higher acceptance of this technique, gallbladders are now removed much earlier than they used to be. With the increase of cholecystectomies, the diagnosis of unexpected gallbladder carcinoma became more frequent. We report on how to proceed in patients with a diagnosis of gallbladder carcinoma and discuss the additional problems that have arisen since laparoscopic cholecystectomy became established. From June 1990 to December 1999, we performed 6230 cholecystectomies in the surgical department of Moabit Hospital in Berlin. Of these, 42 (0.6%) were identified as carcinoma. There were 37 women and five men, and the mean age was 69 years. In 16 patients (39%), there was a preoperative suspicion of malignancy. In 26 patients (61%), malignancy was suspected intraoperatively or diagnosed postoperatively after pathologic examination of the resected gallbladder. In these patients, an open repeat operation was necessary in seven cases to achieve an adequate curative resection and staging. This involved additional liver bed resection and lymph node dissection of the hepatoduodenal ligament. Abdominal wall (port site) recurrence in the absence of distant metastasis was present only in two patients. We recommend removal using a bag in all gallbladders with wall thickening, irregularities, or scleroatrophic calcified gallbladder area. In stage Tis or T1, laparoscopic cholecystectomy is sufficient. In stage T2 and T3, we perform a repeat operation with liver bed resection and lymphadenectomy.

US$19.90

DOI: 10.1007/s004230000177


Other references

Premakumari S.; Devadas R.P., 1990: Socio cultural impact of the preschool feeding program. Indian Journal of Nutrition & Dietetics 27(1): 1-6

Oravcova, V.; Hadelova, D.; Literak, I., 2015: Vancomycin-resistant Enterococcus faecium with vanA gene isolated for the first time from wildlife in Slovakia. NlmCategory="UNASSIGNED">Corvids have been identified as an important vector of vancomycin-resistant enterococci (VRE) in several European countries. The aim of this study was to assess the prevalence of VRE in wildlife in Slovakia an...

Do, C.W.i; Peterson Yantorno, K.; Mitchell, C.H.; Civan, M.M., 2003: CAMP-activated maxi-Cl- channels in native bovine pigmented ciliary epithelial cells Implications on the net secretion of aqueous humor. Journal of General Physiology 122(1): 42a, July

Hanes, J.M., 2014: Science and religion: think local. Science 346(6207): 309-309

Ehrstrom, M.-C., 1934: Clinical significance of total serum calcium estimations. The first part consists of a well arranged review of the literature dealing with serum calcium in normal and pathological conditions. The second part gives the results of the author's own analyses of 20 normal and 140 pathological sera, nearl...

Karis J.McFarlane,Margaret S.Torn,Paul J.Hanson,Rachel C.Porras…, 2013: Comparison of soil organic matter dynamics at five temperate deciduous forests with physical fractionation and radiocarbon measurements. Forest soils represent a significant pool for carbon sequestration and storage, but the factors controlling soil carbon cycling are not well constrained. We compared soil carbon dynamics at five broadleaf forests in the Eastern US that vary in cli...

Adamantidis, A.; de Lecea, L., 2008: The hypocretins as sensors for metabolism and arousal. Sleep disturbances are associated with hormonal imbalances and may result in metabolic disorders including obesity and diabetes. Therefore, circuits controlling both sleep and metabolism are likely to play a role in these physiopathological condit...

Grumet, F.C., 1972: Genetic control of the immune response a selective defect in immunologic immuno globulin g memory in nonresponder mice. Journal of Experimental Medicine 135(1): 110-125

Tarro, G.; Sabin, A.B., 1970: Increase in preexisting cellular antigen-combining groups at different times after infection with different viruses. During the course of experiments designed to determine whether infection of normal cells with certain strains of Herpesvirus hominis (HSV) gives rise to a specific neoantigen, presumably characteristic for human malignant cells ("HeLa G"...

Camaschella, C.; Kattamis, A.C.; Petroni, D.; Roetto, A.; Sivera, P.; Sbaiz, L.; Cohen, A.; Ohene-Frempong, K.; Trifillis, P.; Surrey, S.; Fortina, P., 1997: Different hematological phenotypes caused by the interaction of triplicated alpha-globin genes and heterozygous beta-thalassemia. The pathophysiology and clinical severity of beta-thalassemia are related to the degree of alpha/non-alpha-chain imbalance. A triplicated alpha-globin gene locus can exacerbate effects of excess alpha-chains caused by a defective beta-globin gene,...