World Journal of Surgery

, Volume 29, Issue 9, pp 1106–1109 | Cite as

Long-term Survival of Patients with Gallbladder Cancer Detected during or after Laparoscopic Cholecystectomy

  • Tomotaka Akatsu
  • Masakazu Ueda
  • Motohide Shimazu
  • Go Wakabayashi
  • Koichi Aiura
  • Minoru Tanabe
  • Shigeyuki Kawachi
  • Hiromu Kido
  • Masaki Kitajima
Original Scientific Report


Little evidence is available regarding long-term survival of patients with gallbladder cancer that is discovered at the time of laparoscopic cholecystectomy (LC). Therefore the present study was performed to evaluate long-term outcomes of this disease. Of 1546 patients who underwent LC for benign gallbladder disease between January 1992 and January 2002, 8 patients (0.5%) had cancers that were found during or after LC. The median follow-up period was 55 months (range: 36–142 months). The gallbladder was resected without perforation in all cases. During surgery there was a suspicion of malignancy in 6 of 8 cases. Frozen section analysis showed that 2 had TNM stage Tis tumors, 2 had T1a tumors, and 2 had T2 tumors. Two patients with T2 tumors were immediately converted to extended cholecystectomy. The final pathology revealed another 2 tumors, and demonstrated that 3 patients had Tis tumors, 3 had T1a tumors, and 2 had T2N0M0 tumors. None of the patients underwent additional surgery. All patients survived with no evidence of recurrence during the median follow-up of 55 months. In conclusion, before and during LC, we have not overlooked T2 or more advanced tumor, which requires additional procedures for curative resection. This might result in good survival. We consider that an intensive preoperative work-up and meticulous inspection of the opened gallbladder should be mandatory to detect gallbladder cancer in patients who undergo LC. At present, this is not routinely practiced.


  1. 1.
    Piehler JM, Crichlow RW. Primary carcinoma of the gallbladder. Surg. Gynecol. Obstet. 1978;147:929–942PubMedGoogle Scholar
  2. 2.
    Jones RS. Carcinoma of the gallbladder. Surg. Clin. North. Am. 1990;70:1419–1428PubMedGoogle Scholar
  3. 3.
    Cubertafond P, Gainant A, Cucchiaro G. Surgical treatment of 724 carcinomas of the gallbladder. Results of the French Surgical Association Survey. Ann. Surg. 1994;219:275–280PubMedGoogle Scholar
  4. 4.
    Donohue JH, Nagorney DM, Grant CS, et al. Carcinoma of the gallbladder. Does radical resection improve outcome? Arch. Surg. 1990;125:237–241PubMedGoogle Scholar
  5. 5.
    Oberfield RA, Rossi RL. The role of chemotherapy in the treatment of bile duct cancer. World J. Surg. 1988;12:105–108CrossRefPubMedGoogle Scholar
  6. 6.
    Takada T, Kato H, Matsushiro T, et al. Comparison of 5-fluorouracil, doxorubicin and mitomycin C with 5-fluorouracil alone in the treatment of pancreatic-biliary carcinomas. Oncology 1994;51:396–402PubMedGoogle Scholar
  7. 7.
    Yeh CN, Jan YY, Chen MF. Management of unsuspected gallbladder carcinoma discovered during or following laparoscopic cholecystectomy. Am. Surg. 2004;70:256–258PubMedGoogle Scholar
  8. 8.
    Suzuki K, Kimura T, Ogawa H. Is laparoscopic cholecystectomy hazardous for gallbladder cancer? Surgery 1998;123:311–314CrossRefPubMedGoogle Scholar
  9. 9.
    American Joint Commisssion on Cancer. Cancer Staging Manual, 6th ed. Philadelphia,JB Lippincott, 2002Google Scholar
  10. 10.
    Southern Surgeons Club. A prospective analysis of 1518 laparoscopic cholecystectomies. N. Engl. J. Med. 1991;324:1073–1078Google Scholar
  11. 11.
    Legorreta AP, Silber JH, Costantino GN, et al. Increased cholecystectomy rate after the introduction of laparoscopic cholecystectomy. J.A.M.A. 1993;270:1429–1432PubMedGoogle Scholar
  12. 12.
    Paolucci V, Schaeff B, Schneider M, et al. Tumor seeding following laparoscopy: international survey. World J. Surg. 1999;23:989–995CrossRefPubMedGoogle Scholar
  13. 13.
    Sugiyama M, Xie XY, Atomi Y, et al. Differential diagnosis of small polypoid lesions of the gallbladder: the value of endoscopic ultrasonography. Ann. Surg. 1999;229:498–504CrossRefPubMedGoogle Scholar
  14. 14.
    Choi WB, Lee SK, Kim MH, et al. A new strategy to predict the neoplastic polyps of the gallbladder based on a scoring system using EUS. Gastrointest. Endosc. 2000;52:372–379CrossRefPubMedGoogle Scholar
  15. 15.
    Shirai Y, Yoshida K, Tsukada K, et al. Inapparent carcinoma of the gallbladder. An appraisal of a radical second operation after simple cholecystectomy. Ann. Surg. 1992;215:326–331PubMedGoogle Scholar
  16. 16.
    de Aretxabala XA, Roa IS, Burgos LA, et al. Curative resection in potentially resectable tumours of the gallbladder. Eur. J. Surg. 1997;163:419–426PubMedGoogle Scholar
  17. 17.
    Yamaguchi K, Tsuneyoshi M. Subclinical gallbladder carcinoma. Am. J. Surg. 1992;163:382–386CrossRefPubMedGoogle Scholar
  18. 18.
    Tsukada K, Kurosaki I, Uchida K, et al. Lymph node spread from carcinoma of the gallbladder. Cancer 1997;80:661–667CrossRefPubMedGoogle Scholar
  19. 19.
    Shirai Y, Yoshida K, Tsukada K, et al. Early carcinoma of the gallbladder. Eur. J. Surg. 1992;158:545–548PubMedGoogle Scholar
  20. 20.
    Chijiiwa K, Tanaka M. Carcinoma of the gallbladder: an appraisal of surgical resection. Surgery 1994;115:751–756PubMedGoogle Scholar
  21. 21.
    Onoyama H, Yamamoto M, Tseng A, et al. Extended cholecystectomy for carcinoma of the gallbladder. World J. Surg. 1995;19:758–763CrossRefPubMedGoogle Scholar
  22. 22.
    Aoki T, Tsuchida A, Kasuya K, et al. Is frozen section effective for diagnosis of unsuspected gallbladder cancer during laparoscopic cholecystectomy? Surg. Endosc. 2002;16:197–200CrossRefGoogle Scholar
  23. 23.
    Suzuki S, Yokoi Y, Kurachi K, et al. Appraisal of surgical treatment for pT2 gallbladder carcinomas. World J. Surg. 2004;28:160–165CrossRefPubMedGoogle Scholar
  24. 24.
    Chijiiwa K, Nakano K, Ueda J, et al. Surgical treatment of patients with T2 gallbladder carcinoma invading the subserosal layer. J. Am. Coll. Surg. 2001;192:600–607CrossRefPubMedGoogle Scholar
  25. 25.
    Ohtsuka M, Miyazaki M, Itoh H, et al. Routes of hepatic metastasis of gallbladder carcinoma. Am. J. Clin. Pathol. 1998;109:62–68PubMedGoogle Scholar

Copyright information

© Société Internationale de Chirurgie 2005

Authors and Affiliations

  • Tomotaka Akatsu
    • 1
  • Masakazu Ueda
    • 1
  • Motohide Shimazu
    • 1
  • Go Wakabayashi
    • 1
  • Koichi Aiura
    • 1
    • 2
  • Minoru Tanabe
    • 1
  • Shigeyuki Kawachi
    • 1
  • Hiromu Kido
    • 1
  • Masaki Kitajima
    • 1
  1. 1.Department of SurgeryKeio University School of MedicineShinjyuku-kuJapan
  2. 2.Center for Diagnostic and Therapeutic EndoscopyKeio University School of MedicineShinjyuku-kuJapan

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