Preoperative diagnoses and identification rates of unexpected gallbladder cancer

Abstract

Background Unexpected gallbladder cancer (UGBC) is sometimes found in the resected gallbladder of patients during or after surgery. Some reports have indicated UGBC identification rates for all gallbladder surgeries, but scarce data are available for the UGBC identification rates for specific gallbladder diseases. The present study was performed to clarify UGBC rates and the factors suspicious for UGBC categorized according to preoperative diagnoses, in patients undergoing laparoscopic cholecystectomy (LSC). Methods We recorded data for all LSC surgeries performed in the Department of Surgery, Sada Hospital, Japan since 1991, and analyzed the 28-year data. We used the chi-square test and Kaplan-Meier analysis for this retrospective case-control study. Results The UGBC identification rate was 0.69% (63/9186 patients). The UGBC identification rates categorized according to the preoperative diagnoses were 1.3% (13/969) for acute cholecystitis, 2.4% (16/655) for benign tumor, 2.0% (28/1383) for chronic cholecystitis or cholecystitis, and 0.054% (3/5585) for cholecystolithiasis. The percentage of older patients (� 60 years) was significantly higher in UGBCs compared with cases finally diagnosed as benign in each group categorized according to the preoperative diagnoses (p�0.0014), except for cholecystolithiasis. In cases pre-diagnosed as benign tumor, UGBCs were associated with higher rates of thickened gallbladder wall compared with benign tumor (69.2% vs. 27.9%, respectively; p = 0.0011). UGBCs pre-diagnosed as acute cholecystitis had higher T2-T4 rates (100% vs. 64.3%, respectively; p<0.05) and lower survival rates (p = 0.0149) than UGBCs pre-diagnosed with chronic cholecystitis. Conclusions UGBC identification rates depend on the preoperative diagnosis and range from 0.054% to 2.4%. Older age (� 60 years) could be related to UGBC, and a pre-diagnosis of acute

Effect of Microscope Combined with Wechat Smart Platform on Clinical Efficacy and Gastrointestinal Function of Patients with Cholecystolithiasis Combined with Common Bile Duct Stones

“…The number of calculi was less than 5 and the maximum diameter of calculi was less than 2 cm; patients and their families were fully informed of the study contents and signed relevant agreements. Exclusion criteria are as follows: patients with recurrent choledocholithiasis [ 14 , 15 ]; patients with other gallbladder diseases; patients with a history of abdominal surgery; patients with malignant tumors; female patients with choledocholithiasis in special physiological periods such as pregnancy, puerperium, and lactation; persons with mental illness; and those who refuse to sign informed consent [ 16 ].…”

Practices in the Management of Incidental Gallbladder Cancer

“…This is because, there is a lot of confusion even in the textbooks and published literature about the exact definition of iGBC; some reports include even cases suspected on imaging, during the operation or in the GB specimen on naked eye examination in the operation theater as iGBC. [21][22][23] This needs to be corrected.…”

Essential updates 2019/2020: Surgical treatment of gallbladder cancer

“…In these studies, the frequency of IGBC was reported to be between 0.11% and 2.5%, [28][29][30][31][32][33][34][35] and Fujiwara et al reported that the incidence of IGBC in cholelithiasis was 0.054%, whereas in acute cholecystitis, the incidence was as high as 1.3%, with more advanced cases. 36 Figueiredo et al also reported that 49 (0.77%) of 6329 cholecystectomy cases had IGBC, and while 23 (0.38%) of 5931 were elective surgery cases, a higher rate of 26 (6.53%) of 398 were emergency surgery cases. 28 In recent years, EUS-guided gallbladder drainage (EUS-GBD) for acute cholecystitis has been performed in specialized centers, and the pooled proportion of perforations in a recent meta-analysis of EUS-GBD was 3.7%-6.7%.…”

“…In 2019‐2020, seven case‐controlled studies (Table 1) and nine case‐series studies were published on IGBC. In these studies, the frequency of IGBC was reported to be between 0.11% and 2.5%, 28–35 and Fujiwara et al reported that the incidence of IGBC in cholelithiasis was 0.054%, whereas in acute cholecystitis, the incidence was as high as 1.3%, with more advanced cases 36 . Figueiredo et al also reported that 49 (0.77%) of 6329 cholecystectomy cases had IGBC, and while 23 (0.38%) of 5931 were elective surgery cases, a higher rate of 26 (6.53%) of 398 were emergency surgery cases 28 .…”