PMID- 31267910
OWN - NLM
STAT- MEDLINE
DCOM- 20190708
LR  - 20190708
IS  - 1555-9823 (Electronic)
IS  - 0003-1348 (Linking)
VI  - 85
IP  - 6
DP  - 2019 Jun 1
TI  - Unexpected Gallbladder Cancer during or after Laparoscopic Cholecystectomy: Risk 
      Factors and Experience of Diagnosis and Treatment of 22 Cases.
PG  - 671-675
AB  - This study aims to provide some experience in diagnosis and treatment of 
      unexpected gallbladder cancer (UGBC) and find the major risk factors. 
      Retrospective data were collected and analyzed on 22 patients who were diagnosed 
      with UGBC during or after laparoscopic cholecystectomy from January 2013 to 
      January 2018 at our hospital. Average age of the patients was (60.2 +/- 12.8) years 
      (range, 42-83 years). Among them, there were 6 men and 16 women. Gallbladder 
      stones, atrophic gallbladder, uneven thickened wall of the gallbladder, and 
      choledocholithiasis were found to be the major risk factors. Eight patients 
      (36.4%) were diagnosed intraoperatively. Seven cases (31.8%) were at the T1 
      stage; of these, three were treated with laparoscopic cholecystectomy; two were 
      converted to cholecystectomy; and two underwent cholecystectomy, lymph node 
      dissection, and liver resection. Eight (36.4%) T2 patients, five (22.7%) T3 
      patients, and one T4 patient had radical cholecystectomy. Partial cholecystectomy 
      and cholecystotomy were carried out in another T4 patient. T1 patients did not 
      receive chemotherapy or radiotherapy. Eleven had chemotherapy and four received 
      chemoradiotherapy. The follow-up period ranged from six months to five years. The 
      one-year survival rate for T1 to T4 patients was 100 per cent, 75 per cent, 40 
      per cent, and 0 per cent, respectively. A high index of clinical suspicion of 
      UGBC is needed if one patient suffered from both gallbladder stones and 
      choledocholithiasis with atrophic gallbladder or uneven thickened wall of the 
      gallbladder preoperatively. To avoid more UGBC and reoperation, imaging 
      examinations combined with tumor marker tests and intraoperative histopathologic 
      examination are highly recommended.
FAU - Zhong, Hua
AU  - Zhong H
FAU - Hao, Tuan Tuan
AU  - Hao TT
FAU - Chen, Yong
AU  - Chen Y
FAU - Luo, Fang
AU  - Luo F
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - Am Surg
JT  - The American surgeon
JID - 0370522
SB  - IM
MH  - Adult
MH  - Age Factors
MH  - Aged
MH  - *Cause of Death
MH  - Cholecystectomy, Laparoscopic/adverse effects/*methods
MH  - Cholelithiasis/diagnostic imaging/*surgery
MH  - Databases, Factual
MH  - Female
MH  - Gallbladder Neoplasms/diagnostic imaging/mortality/*pathology/*surgery
MH  - Humans
MH  - Incidence
MH  - *Incidental Findings
MH  - Intraoperative Complications/pathology
MH  - Male
MH  - Middle Aged
MH  - Postoperative Complications/diagnosis/surgery
MH  - Prognosis
MH  - Reoperation/methods
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Severity of Illness Index
MH  - Sex Factors
MH  - Survival Analysis
EDAT- 2019/07/04 06:00
MHDA- 2019/07/10 06:00
CRDT- 2019/07/04 06:00
PHST- 2019/07/04 06:00 [entrez]
PHST- 2019/07/04 06:00 [pubmed]
PHST- 2019/07/10 06:00 [medline]
PST - ppublish
SO  - Am Surg. 2019 Jun 1;85(6):671-675.