Incidental Gall bladder cancer after Laparoscopic Cholecystectomy for symptomatic cholelithiasis - Our experience

Dr. Wormi Sharon

Volume : VII, Issue : XI, November - 2017

Incidental Gall bladder cancer after Laparoscopic Cholecystectomy for symptomatic cholelithiasis - Our experience

Dr. Wormi Sharon

Abstract :

Background:

Incidental gall bladder carcinoma (IGBC) is an incidental finding of carcinoma diagnosed on histopathological examination of gall bladder specimen removed for symptomatic cholelithiasis. Laparoscopic cholecystectomy (LC) is the accepted standard management for symptomatic cholelithiasis..Gall bladder carcinoma is a highly malignant tumor with a poor prognosis. The incidence of IGBC is around 0.19 – 3.3% in the literature

Aim:

To determine the percentage of gall bladder carcinoma incidentally diagnosed during histopathological examination of cholecystectomy specimens done for gallstone disease.

Material and Methods:

We analyzed the medical records of patients with symptomatic gallstone disease of single surgical unit, who underwent laparoscopic cholecystectomies at Jawaharlal Nehru Institute of Medical Sciences (JNIMS) Hospital, Porompat, Imphal, during the period from 1^st January 2014 to 31^st December 2016.

Results:

A total of 480 laparoscopic cholecystectomies were performed at our surgical unit during the study period of three (3) years. In 7 (1.5%) cases, incidental gallbladder carcinoma was discovered. A laparoscopic cholecystectomy which is performed for benign gall bladder disease rarely results in a diagnosis of unexpected gallbladder cancer. IGBC detected after a cholecystectomy due to cholelithiasis is a rare disease. We found IGBC in 1.5% of cases, which is on a comparable scale to the world literature.

Conclusion:

With the increase of laparoscopic cholecystectomies both elective and urgent performed in our

Centre we observed also an increase of incidentally diagnosed gallbladder neoplasms. Early diagnosis, meticulous peri–operative study and accurate surgical strategy are essential factors to obtain good results in incidental gallbladder cancer. This cancer is more common in females and in people over 60 years of age.