Port site and distant metastases of gallbladder cancer after laparoscopic cholecystectomy diagnosed by positron emission tomography

Hu, Jianbin; Sun, Xiao; Xu, Jing; He, Chao

doi:10.3748/wjg.14.6428

Cited by 35 publications

(19 citation statements)

References 11 publications

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“…LC in patients with GBC has been associated with an increased incidence of peritoneal metastasis and port site recurrences. The incidence of port site recurrences in IGBC after LC was 0-40 % in various reported series [13][14][15][16]. The proposed theories for port site recurrences include gallbladder perforation and bile spillage, direct physical and chemical influence of pneumoperitoneum, improper specimen extraction and increased abdominal pressure on tumour cell diffusion [13,14,17].…”

Section: Laparoscopic Cholecystectomy and Port Site Recurrencementioning

confidence: 99%

Incidentally Detected Gallbladder Cancer- The Controversies and Algorithmic Approach to Management

et al. 2012

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Incidentally discovered gallbladder cancer (IGBC) is defined as the gallbladder cancer (GBC) diagnosed during or after the cholecystectomy done for unsuspected benign gallbladder disease. Laparoscopic cholecystectomy (LC) is the most common procedure performed for benign gallbladder disease worldwide. Majority of GBC patients have associated gallstones. With the advent of ultrasonography more patients are being diagnosed with gallstones and are being subjected to cholecytectomy. IGBC is found in 0.2-2.9 % of all cholecytectomies done for gallstone disease. It represents 27-41 % of all GBC. Patients with IGBC having Tis and T1a stage, with negative cystic duct margin can be treated by simple cholecystectomy alone. Patients with stage T1b and beyond should undergo restaging, and should be treated with radical re -resection (R0). Residual disease is found in 40-76 % patients on re-exploration. The survival rates of patients undergoing re resection for IGBC is similar to those undergoing primary radical surgery. LC is contraindicated in patients with GBC. Patients presenting post LC should undergo radical re-resection and additional port site excision, as they have a high incidence of port site metastasis. At cholecystectomy for benign gallbladder disease all gallbladder specimens should be opened before closing abdomen and if available all suspicious specimens should be sent for immediate frozen section. All gallbladder specimens should be subjected to histopathology examination to avoid missing GBC. The surgeon should have a high index of suspicion for GBC if encountering difficult cholecystectomy for a benign disease, and in patients with atypical clinical and ultrasound findings in high incidence areas.

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Section: Laparoscopic Cholecystectomy and Port Site Recurrencementioning

confidence: 99%

Incidentally Detected Gallbladder Cancer- The Controversies and Algorithmic Approach to Management

et al. 2012

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“…It has been employed for staging and restaging of GBC [10,11], as well as for its prognostication [12]. Many reports have also demonstrated the utility of 18 F-FDG PET/CT for detection of port site metastasis in GBC [5,8]. Three major implications of 18 F-FDG PET/CT can be determined in this clinical setting.…”

Section: Discussionmentioning

confidence: 99%

“…Very rarely, the primary GBC may remain occult even at histopathology and present later as port site metastasis [3,4]. Functional imaging with 18 F-flurodeoxyglucose ( 18 F-FDG) positron emission tomography/computed tomography (PET/CT) has been employed for diagnosis of port site metastasis after laparoscopic surgery [5,6]. We here present two cases of late port site recurrence from occult GBC after laparoscopic cholecystectomy for cholelithiasis and discuss the role of 18 F-FDG PET/CT in this setting.…”

Section: Introductionmentioning

confidence: 99%

Late Port Site Metastasis from Occult Gall Bladder Carcinoma After Laparoscopic Cholecystectomy for Cholelithiasis: The Role of 18F-FDG PET/CT

Sharma

Chatterjee

2014

Nucl Med Mol Imaging

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Late port site metastasis of gall bladder carcinoma (GBC) after laparoscopic cholecystectomy is a rare finding. Rarer still is such a presentation where the GBC remained occult at histopathology. 18 F-flurodeoxyglucose ( 18 F-FDG) positron emission tomography/computed tomography (PET/ CT) can play an important role in this setting by supporting the diagnosis of port site metastasis, by demonstrating additional sites of metastasis, if any, and by ruling out any other primary site. We here present two such patients with late port site metastasis of occult GBC after laparoscopic cholecystectomy for cholelithiasis and discuss the role of 18 F-FDG PET/CT in this setting.

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“…(2) We report the case of a 45-year-old woman with a single PSM from papillary adenocarcinoma, who presented 28 months after she had undergone LC for calculus cholecystitis. The primary malignancy remained elusive in our patient even after thorough investigation -there was no evidence of malignancy anywhere in the body, except for a peripancreatic lymph node that had no indication of malignancy.…”

Section: Introductionmentioning

confidence: 99%

Delayed presentation of port-site metastasis from an unknown gastrointestinal malignancy following laparoscopic cholecystectomy

Rao¹,

Rathod²,

Kamble³

et al. 2014

smedj

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Port-site metastasis (PSM) is often encountered during laparoscopic surgery in patients with malignancy. We report a 45-year-old woman who presented with a single PSM from papillary adenocarcinoma after undergoing laparoscopic cholecystectomy for calculus cholecystitis. Post cholecystectomy, a diagnosis of chronic cholecystitis was confirmed on histopathology. The patient presented with a mass at the site of epigastric port 28 months after surgery. PSM was suspected on clinical examination, which was supported by findings on computed tomography and further confirmed by fine-needle aspiration cytology of the lump. The patient underwent surgical clearance of the mass, and histopathological examination proved the lesion to be papillary adenocarcinoma. The site of the primary tumour was not detected even after thorough examination. Based on the histopathology report following local surgical clearance, the patient was started on chemotherapy. This case is unusualbecause of the long delay prior to the presentation of PSM and the unknown primary malignancy.

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Port site and distant metastases of gallbladder cancer after laparoscopic cholecystectomy diagnosed by positron emission tomography

Abstract: Patient 1A 72-year-old woman presented with right upper quadrant pain and fever. She had a history of cholelithiasis documented by ultrasound, and intermittent attacks of biliary colic over 2 years. She was diagnosed with cholelithiasis and cholecystitis. She received laparoscopic

Cited by 35 publications

References 11 publications

Incidentally Detected Gallbladder Cancer- The Controversies and Algorithmic Approach to Management

Incidentally Detected Gallbladder Cancer- The Controversies and Algorithmic Approach to Management

Late Port Site Metastasis from Occult Gall Bladder Carcinoma After Laparoscopic Cholecystectomy for Cholelithiasis: The Role of 18F-FDG PET/CT

Delayed presentation of port-site metastasis from an unknown gastrointestinal malignancy following laparoscopic cholecystectomy

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