Incidental gallbladder cancer after cholecystectomy: 1990 to 2014
Received 17 February 2016
Accepted for publication 6 May 2016
Published 8 August 2016 Volume 2016:9 Pages 4913—4916
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Manfred Beleut
Peer reviewer comments 3
Editor who approved publication: Professor Min Li
Tadeusz Dorobisz,1,2 Karolina Dorobisz,3 Mariusz Chabowski,1,4 Wiktor Pawłowski,1 Dawid Janczak,5 Dariusz Patrzałek,1,2 Dariusz Janczak1,4
1Department of Surgery, 4th Military Teaching Hospital, 2Department of Clinical Basics of Physiotherapy, Faculty of Health Science, 3Department of Otolaryngology, Head and Neck Surgery, 4Department of Surgical Specialties, 5Department of Palliative Care Nursing, Faculty of Health Science, Wroclaw Medical University, Wroclaw, Poland
Introduction: Cancer of the gallbladder is a serious diagnostic and therapeutic problem. According to the literature, 30% of cases are not confirmed before surgery. Other cases are detected incidentally by histopathology. Clinical trials and meta-analyses show that incidental gallbladder cancer (iGBC) occurs in 0.19%–2.8% of patients after cholecystectomy. The aim of this study was to analyze the incidence and severity of iGBC in cholecystectomy procedures performed in the surgical department at the 4th Military Teaching Hospital in Wroclaw during the years 1990–2014.
Patients and methods: In the years 1990–2014, a total of 7,314 cholecystectomies were performed in the surgical department because of cholecystolithiasis: 6,145 were performed using the laparoscopic approach (84.02%), 867 were performed as open surgery (11.8%), and 302 cases required conversion (5.1%). In this group, 5,214 of the patients were females (71.3%) and 2,100 were males (28.7%), with an average age of 54.7 years.
Results: We found 64 iGBC cases which were confirmed by histopathology. This represented 0.87% of all cases. In this group, 50 patients were females (78.1%) and 14 were males (21.8%), with an average age of 67.1 years. Of this group, 40 patients underwent a classic cholecystectomy, while 24 underwent laparoscopic procedures, out of which 13 cases ultimately required traditional surgery. The histopathology showed 15 carcinomas that were classified as G1 (23.4%), 28 were G2 (43.75%), and 21 were G3 (32.8%).
Conclusion: iGBC detected after a cholecystectomy due to cholecystolithiasis is a rare disease. We found iGBC in 0.87% of cases, which is on a comparable scale to the world literature. In the case of cancer, we frequently found it necessary to convert to an open surgical procedure. This cancer is more common in females and in people over 60 years of age.
Keywords: incidental cancer of the gallbladder, cholecystectomy, cholecystolithiasis, laparoscopic cholecystectomy, radicality
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