Clinical Analysis Of Laparoscopic Chlecystectomy And Unsuspected Gallbladder Carcinoma

【Objective】To summary the clinical experience of unsuspected gallbladder carcinoma during or after laparoscopic cholecystectomy and to discuss the methods of avoiding loss of diagnosis and improving the effect of treatment.【Methods】We performed a retrospectively analysis of 48 patients who were treated from January 2001 to December 2010 in our hospital for unsuspected gallbladder carcinoma during or after laparoscopic cholecystectomy.[Results]The clinical characters of 48 cases were all in accordance with high-risk of gallbladder carcinoma.2 cases were stage T1a,7 were stage T1b,37 were stage T2, 2were stage T3,0 were stage T4, according to TNM classification respectively. The 18 cases were diagnosed by frozen section examination, and others were diagnosed by pathology after operation. For the cases of stage Tla, all were performed laparoscopic cholecystectomy only. For the case of stage T1b,2 cases were performed radical reoperation, and others only were performed laparoscopic cholecystectomy. For the case of stage T2,8 cases were performed radical reoperation, and 1 case were performed extended radical reoperation, and other patients refused radical operation. 23 cases of stage T2 are alive during the follow-up, the median and mean survival time of stage T2 performed radical operation is 50(53.33±14.79) months, and the median and mean survival time of stage T2 performed laparoscopic cholecystectomy is 26(40.67±9.62). The survival time of them is no significant difference(P=0.46).【Conclusion】If the patient has the risk of gallbladder carcinoma, we need to check carefully pre-or intra-operation. During the operation, the frozen section examination is useful for the diagnosis of unsuspected gallbladder carcinoma. The literatures and NCCN guide line showed that cholecystectomy is enough for the cases of stage Tla, and we can select radical resection or other therapy for the stage T2, T3, T4.