Incidental gallbladder cancers: Our clinical experience and review of the literature

Abstract

Objective: Gallbladder carcinomas are rare and aggressive neoplasms. They are usually advanced at the time of diagnosis. We aimed to evaluate incidental gallbladder cancers in our clinic, in terms of patients' demographics, diagnosis, treatment and follow-up, and compared our results with the literature. Material and Methods:Patients who underwent laparoscopic cholecystectomy in the last 9 years were retrospectively reviewed, and features of the patients diagnosed with gallbladder cancer after histopathological evaluation were further evaluated.Results: Thirteen patients were female and two were male. The mean age was 67 years. Additional treatment was applied in seven patients. All patients were operated on laparoscopically, with conversion to open surgery in four patients. The rate of incidental gallbladder cancer was 0.17% in our patients. Survival rates were found to be 22.2% in patients who had been operated at least 5 years ago. Conclusion:Surgery is the only curative treatment in gallbladder cancers; however, they are usually at advanced stages at the time of diagnosis. In incidental gallbladder cancers, survival can be prolonged with appropriate treatment models if they are identified at early stages. The relatively low rates that have been reported in our population may be due to geographical differences and problems in study design. Keywords: Incidental, gallbladder, cancer INTRODUCTIONLaparoscopic cholecystectomy is accepted as the gold standard for the treatment of benign gallbladder diseases in the world due to reduced postoperative pain, early oral intake, early discharge and better cosmetic results for the last 20 years, and is being implemented with low morbidity. There has not been a significant increase in the early detection rate of gallbladder cancer (GBC), which remains asymptomatic in early stages, despite advances in technology and widespread use of techniques such as ultrasound (US) and abdominal computed tomography (CT), with an incidence of 0,54-2,1% (1, 2). Overall, there is preoperative suspicion of GBC in only 30% of patients, while the remaining 70% are diagnosed in the postoperative pathologic examinations (3). In other words, in the literature it has been proven that 1 cancer is detected out of every 100 laparoscopic cholecystectomies (4). Maximillian Stoll has mentioned GBC for the first time in Vienna in 1777 (5). After many years, Nevin et al. (6) has defined the first GBC staging and survival rates after open cholecystectomy. Drouard et al. (7) showed port site metastases in 1991. Gallbladder cancer is a very aggressive disease, with a 5-year survival rate of 3-13% (8), and a mean survival of 3-11 months (9). However, especially with aggressive surgical approaches applied in some centers in Japan, satisfactory results can be obtained (10). The underlying cause of this rate is the too late emergence of symptoms such as pain and jaundice (6), and advanced stage on diagnosis (T3, T4).Incidental GBC refers to cancers that were not diagnosed preoperatively but detected by postoper...

Incindental Detection of Gall Bladder Carcinoma Post Cholecystectomy Done for Benign Lesions- A Study in a Tertiary Care Centre of North East India

“…The Incidence of Incidental Gall Bladder Carcinoma is Different in Different Regions of the world Depending on Ethnicity and Geographic Diversity[10][11][12][13][14][15][16][17][18][19][20] …”