Incidental Gallbladder Cancer after Laparoscopic Cholecystectomy for Cholelithiasis, and Factors Affecting the Prognosis: A Single-center Experience

Aim:Despite surgical and radiological innovations, gallbladder cancer (GC) is usually diagnosed incidentally by the pathological examination of the cholecystectomy specimens, and it is defined as incidental GC (IGC).Methods:Medical files of patients, who underwent cholecystectomy, were analyzed retr...

Full description

Bibliographic Details
Main Authors: Süleyman Demiryas, Ozan Akıncı, Nuray Kepil, İhsan Taşçı
Format: Article
Language:English
Published: Galenos Yayinevi 2019-09-01
Series:Haseki Tıp Bülteni
Subjects:
Online Access: http://www.hasekidergisi.com/archives/archive-detail/article-preview/ncidental-gallbladder-cancer-after-laparoscopic-ch/30318
_version_ 1828015400064909312
author Süleyman Demiryas
Ozan Akıncı
Nuray Kepil
İhsan Taşçı
author_facet Süleyman Demiryas
Ozan Akıncı
Nuray Kepil
İhsan Taşçı
author_sort Süleyman Demiryas
collection DOAJ
description Aim:Despite surgical and radiological innovations, gallbladder cancer (GC) is usually diagnosed incidentally by the pathological examination of the cholecystectomy specimens, and it is defined as incidental GC (IGC).Methods:Medical files of patients, who underwent cholecystectomy, were analyzed retrospectively. We investigated the relationship between clinicopathological features and survival in patients with IGC.Results:We performed cholecystectomy surgery in 6225 patients in 20 years. Only 21 patients with IGC were included in this study. The distribution of the tumor stages was as follows: in situ cancer (n=1), T1 (n=2), T2 (n=7), and T3 (n=11). Tumor subtypes were identified as adenocarcinoma (n=16), neuroendocrine tumor (n=2), mucinous carcinoma (n=2), and adenosquamous carcinoma (n=1). Advanced ‘‘T stage’’, conversion of laparoscopic cholecystectomy to open cholecystectomy (OCC), positive surgical margins, positive lymphovascular invasion and increased levels of pre-operative alkaline phosphatase (ALP) were found to be associated with poor survival.Conclusion:In case of OCC or high preoperative ALP activity in cholelithiasis, IGC should be kept in mind. Pathology report on IGC should give information on all histopathological prognostic features in order to avoid loss of time associated with re-examination of specimens due to absence of sufficient information in the initial pathology report and enable the surgical team to perform re-operation for T1b tumors or more advanced IGC in a timely fashion.
first_indexed 2024-04-10T10:17:55Z
format Article
id doaj.art-872c96555f7f42b0bd43c707967e8d6f
institution Directory Open Access Journal
issn 1302-0072
2147-2688
language English
last_indexed 2024-04-10T10:17:55Z
publishDate 2019-09-01
publisher Galenos Yayinevi
record_format Article
series Haseki Tıp Bülteni
spelling doaj.art-872c96555f7f42b0bd43c707967e8d6f2023-02-15T16:21:47ZengGalenos YayineviHaseki Tıp Bülteni1302-00722147-26882019-09-0157329630310.4274/haseki.galenos.2019.512113049054Incidental Gallbladder Cancer after Laparoscopic Cholecystectomy for Cholelithiasis, and Factors Affecting the Prognosis: A Single-center ExperienceSüleyman Demiryas0Ozan Akıncı1Nuray Kepil2İhsan Taşçı3 İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Department of General Surgery, İstanbul, Turkey Hakkari State Hospital, Clinic of General Surgery, Hakkari, Turkey İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Department of Pathology, İstanbul, Turkey İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Department of General Surgery, İstanbul, Turkey Aim:Despite surgical and radiological innovations, gallbladder cancer (GC) is usually diagnosed incidentally by the pathological examination of the cholecystectomy specimens, and it is defined as incidental GC (IGC).Methods:Medical files of patients, who underwent cholecystectomy, were analyzed retrospectively. We investigated the relationship between clinicopathological features and survival in patients with IGC.Results:We performed cholecystectomy surgery in 6225 patients in 20 years. Only 21 patients with IGC were included in this study. The distribution of the tumor stages was as follows: in situ cancer (n=1), T1 (n=2), T2 (n=7), and T3 (n=11). Tumor subtypes were identified as adenocarcinoma (n=16), neuroendocrine tumor (n=2), mucinous carcinoma (n=2), and adenosquamous carcinoma (n=1). Advanced ‘‘T stage’’, conversion of laparoscopic cholecystectomy to open cholecystectomy (OCC), positive surgical margins, positive lymphovascular invasion and increased levels of pre-operative alkaline phosphatase (ALP) were found to be associated with poor survival.Conclusion:In case of OCC or high preoperative ALP activity in cholelithiasis, IGC should be kept in mind. Pathology report on IGC should give information on all histopathological prognostic features in order to avoid loss of time associated with re-examination of specimens due to absence of sufficient information in the initial pathology report and enable the surgical team to perform re-operation for T1b tumors or more advanced IGC in a timely fashion. http://www.hasekidergisi.com/archives/archive-detail/article-preview/ncidental-gallbladder-cancer-after-laparoscopic-ch/30318 Cholelithiasisincidental gallbladder carcinomaneuroendocrine carcinomalymphovascular invasionlaparoscopic cholecystectomyalkaline phosphatase
spellingShingle Süleyman Demiryas
Ozan Akıncı
Nuray Kepil
İhsan Taşçı
Incidental Gallbladder Cancer after Laparoscopic Cholecystectomy for Cholelithiasis, and Factors Affecting the Prognosis: A Single-center Experience
Haseki Tıp Bülteni
Cholelithiasis
incidental gallbladder carcinoma
neuroendocrine carcinoma
lymphovascular invasion
laparoscopic cholecystectomy
alkaline phosphatase
title Incidental Gallbladder Cancer after Laparoscopic Cholecystectomy for Cholelithiasis, and Factors Affecting the Prognosis: A Single-center Experience
title_full Incidental Gallbladder Cancer after Laparoscopic Cholecystectomy for Cholelithiasis, and Factors Affecting the Prognosis: A Single-center Experience
title_fullStr Incidental Gallbladder Cancer after Laparoscopic Cholecystectomy for Cholelithiasis, and Factors Affecting the Prognosis: A Single-center Experience
title_full_unstemmed Incidental Gallbladder Cancer after Laparoscopic Cholecystectomy for Cholelithiasis, and Factors Affecting the Prognosis: A Single-center Experience
title_short Incidental Gallbladder Cancer after Laparoscopic Cholecystectomy for Cholelithiasis, and Factors Affecting the Prognosis: A Single-center Experience
title_sort incidental gallbladder cancer after laparoscopic cholecystectomy for cholelithiasis and factors affecting the prognosis a single center experience
topic Cholelithiasis
incidental gallbladder carcinoma
neuroendocrine carcinoma
lymphovascular invasion
laparoscopic cholecystectomy
alkaline phosphatase
url http://www.hasekidergisi.com/archives/archive-detail/article-preview/ncidental-gallbladder-cancer-after-laparoscopic-ch/30318
work_keys_str_mv AT suleymandemiryas incidentalgallbladdercancerafterlaparoscopiccholecystectomyforcholelithiasisandfactorsaffectingtheprognosisasinglecenterexperience
AT ozanakıncı incidentalgallbladdercancerafterlaparoscopiccholecystectomyforcholelithiasisandfactorsaffectingtheprognosisasinglecenterexperience
AT nuraykepil incidentalgallbladdercancerafterlaparoscopiccholecystectomyforcholelithiasisandfactorsaffectingtheprognosisasinglecenterexperience
AT ihsantascı incidentalgallbladdercancerafterlaparoscopiccholecystectomyforcholelithiasisandfactorsaffectingtheprognosisasinglecenterexperience