Document Detail


Trocar site seeding of inapparent gallbladder carcinoma during laparoscopic cholecystectomy.
MedLine Citation:
PMID:  8919176     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
There are increasing reports of seeding of tumor at the trocar sites following laparoscopic cholecystectomy in patients with unexpected or inapparent gallbladder carcinoma. A patient is reported here whose primary tumor appeared controlled by surgery and radiation, but who died of the disease after developing implant metastases at three untreated trocar sites. The second case report illustrates the difficulty in identifying gallbladder cancer during laparoscopic cholecystectomy, and the importance of a diligent preoperative effort to establish the diagnosis. Current literature suggests that tumor implantation occurring during laparoscopic cholecystectomy for inapparent carcinoma adversely affects prognosis, and, until the effect of laparoscopy on the spread of this tumor is better understood and controlled, open operation should be performed when carcinoma of the gallbladder is suspected. When laparoscopic cholecystectomy is done for inapparent gallbladder cancer, surgical and adjuvant radiotherapy to the trocar sites appears to improve outcome in association with extended treatment to the gallbladder bed and adjacent areas. Recent reports suggest that progress in diagnostic, surgical, and adjuvant techniques could substantially improve survival in carcinoma of the gallbladder.
Authors:
A M Cotlar; C R Mueller; J W Pettit; E R Schmidt; H V Villar
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Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  Journal of laparoendoscopic surgery     Volume:  6     ISSN:  1052-3901     ISO Abbreviation:  J Laparoendosc Surg     Publication Date:  1996 Feb 
Date Detail:
Created Date:  1997-03-19     Completed Date:  1997-03-19     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  9109598     Medline TA:  J Laparoendosc Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  35-45     Citation Subset:  IM    
Affiliation:
Department of Surgery, Davis-Monthan Air Force Base, Arizona, USA.
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MeSH Terms
Descriptor/Qualifier:
Adenocarcinoma / pathology,  surgery*
Adult
Aged
Aged, 80 and over
Cholecystectomy, Laparoscopic / instrumentation*
Cholelithiasis / pathology,  surgery*
Fatal Outcome
Female
Gallbladder / pathology
Gallbladder Neoplasms / pathology,  surgery*
Humans
Male
Middle Aged
Neoplasm Recurrence, Local / pathology,  surgery
Neoplasm Seeding*
Postoperative Complications / pathology,  surgery
Reoperation

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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