Surgical Endoscopy

, Volume 15, Issue 9, pp 959–961 | Cite as

Abdominal malignancies missed during laparoscopic cholecystectomy

  • A. Wysocki
  • W. Lejman
  • A. Bobrzynski
Original Articles



We present our experience with intra-abdominal malignancies different from gallbladder cancer not diagnosed preoperatively and undiscovered during laparoscopic cholecystectomy


This study involved retrospective analysis of 10 patients hospitalized in the Second Department of General Surgery between 1993 and 2000. In all of them, laparoscopic cholecystectomy had been performed between one week and 21 months earlier.


Primary or metastatic neoplasms were diagnosed in five men and five women patients ages 38 to 79 years. In three patients with colorectal cancer, a radical resection was possible. Nonresectable pancreatic cancer was found in three patients. In one of two patients with gastric cancer, palliative, distal gastrectomy was performed. In a patient who had small bowel cancer with metastasis to the ovary, a radical operation was possible. In one patient, liver metastasis from lung cancer was found.


In patients with atypical symptoms of gall-bladder lithiasis, a thorough workup before laparoscopic cholecystectomy should be performed. During the laparoscopic procedure, a detailed examination of the whole peritoneal cavity is essential. In cases of prolonged convalescence after laparoscopic cholecystectomy, a source of symptoms different from cholelithiasis should be suspected.

Key words

Cancer Laparoscopic cholecystectomy Laparoscopy Missed intra-abdominal malignancies 


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  1. 1.
    Caglikulekci M, Yilmaz S, Kayaalp C, Savkilioglu M (1997) Malignant tumors overlooked at laparoscopic cholecystectomy. Euroasian Congress of Endoscopic Surgery, Istanbul, June, Abstract Book, 112Google Scholar
  2. 2.
    Catheline JM, Turner R, Rizk N, Barat C, Champoult G (1999) The use of diagnostic laparoscopy supported by laparoscopic ultrasonography in the assessment of pancreatic cancer. Surg Endosc 13: 239–245PubMedCrossRefGoogle Scholar
  3. 3.
    Denning DA, Lipshy KA (1996) Missed pathology following laparoscopic cholecystectomy: a cause for concern? Am J Surg 61: 117–120Google Scholar
  4. 4.
    Gal O, Szivos J, Jaberansari MT, Szabo Z (1998) Laparoscopic cholecystectomy: risk of missed pathology of other organs. Surg Endosc 12: 825–827PubMedCrossRefGoogle Scholar
  5. 5.
    Gracie WA, Ransohoff DF (1982) The natural history of silent gall-stones. N Engl J Med 307: 798–800PubMedCrossRefGoogle Scholar
  6. 6.
    Hamaloglu E, Yorganci K, Oner Z, Sayek I (1999) Missed malignancies during laparoscopic cholecystectomy. Hepatogastroenterology 46: 126–129PubMedGoogle Scholar
  7. 7.
    Hanney RM, Bond G, de Costa A (1997) Laparoscopic cholecystectomy: the missed diagnosis. Aust N Z J Surg 67: 166–167PubMedCrossRefGoogle Scholar
  8. 8.
    Heaton KW, Braddon FE, Mountford RA, Hughes AO, Emmett P (1991) Symptomatic and silent gallstones in the community. Gut 32: 316–320PubMedCrossRefGoogle Scholar
  9. 9.
    Junger W, Junger WG, Hutter J, Miller K, Moritz E (1997) Delayed diagnosis of malignant tumors missed at laparoscopic cholecystectomy. Surg Endosc 11: 1010–1012PubMedCrossRefGoogle Scholar
  10. 10.
    Juźków H, Jackowski M, Jędrzejczyk W, Szeliga J, Załucki M, Kadłubowski A (1997) Nowotwory przewodu pokarmowego nierozpoznane podczas operacji laparoskopowych: błąd postępowania czy ryzyko metody. Pol Przeg Chir 69: 1028–1032Google Scholar
  11. 11.
    Lundberg O, Kristofferson (1999) A port-site metastases from gall-bladder cancer after laparoscopic cholecystectomy: results of Swedish survey and review of published reports. Eur J Surg 165: 215–222PubMedCrossRefGoogle Scholar
  12. 12.
    Kalaciński J, Ziaja K, Frączek J (1997) Przeoczone nowotwory jamy brzusznej w czasie cholecystektomii laparoskopowej: analiza materiału. Wiad Lek Supl 1: 246–249Google Scholar
  13. 13.
    McLouchlan GJ, MacIntyre IM (1995) Return to work after laparoscopic cholecystectomy. Br J Surg 82: 239–241CrossRefGoogle Scholar
  14. 14.
    O’Hanlon DM, Doyle JP, Kerin MJ, Flynn JR, O’Donoghue JM (1994) Laparoscopic cholecystectomy: potential for missed pathology. Ann R Col Surg Eng 76: 315–316Google Scholar
  15. 15.
    Olsen AK, Bierkeset OA (1999) Laparoscopic ultrasound (LUS) in gastrointestinal surgery. Eur J Ultrasound 10: 159–170PubMedCrossRefGoogle Scholar
  16. 16.
    Schaeff B, Paolucci V, Thomopoulos J (1998) Port-site recurrences after laparoscopic surgery. Dig Surg 15: 124–134PubMedCrossRefGoogle Scholar
  17. 17.
    Sharp EJ, Springall RG, Theodorou NA (1994) Delayed diagnosis of malignant tumors missed at laparoscopic cholecystectomy. Br J Surg 81: 1649–1650CrossRefGoogle Scholar
  18. 18.
    Slim K, Pezet D, Clark E, Chipponi J (1996) Malignant tumors missed at laparoscopic cholecystectomy. Am J Surg 171: 364–365PubMedCrossRefGoogle Scholar
  19. 19.
    Vitale GC, Collet D, Larson GM, Cheadle WG, Miller FB, Perissat J (1991) Interruption of professional and home activity after laparoscopic cholecystectomy among French and American patients. Eur J Ultrasound 161: 396–398Google Scholar
  20. 20.
    Wysocki A, Bobrzyński A, Krzywoń J, Budzyński A (1999) Laparoscopic cholecystectomy and gallbladder cancer. Surg Endosc 13: 899–901PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2001

Authors and Affiliations

  • A. Wysocki
    • 1
  • W. Lejman
    • 1
  • A. Bobrzynski
    • 1
  1. 1.Department of General SurgeryJagiellonian University, Collegium MedicumKrakowPoland

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