[Missed abdominal neoplasms during laparoscopic cholecystectomy and herniorrhaphy--analysis of material]. / Przeoczone nowotwory jamy brzusznej w czasie cholecystektomii i herniorrhaphii laparoskopowej--analiza materialu.

ABSTRACT

UNLABELLED The authors present 9 cases of overlooking abdomen cavity neoplasma during laparoscopic cholecystectomy (L. Ch.) 8 patients had L. Ch. in other laparoscopic centers. Localisation of the tumors concerned head of pancreas in 3 cases, posterior wall of stomach in 3 patients and splecic flexurae of colon in 2 cases. Patient was reoperated because of painless jaundice in 3 cases, bleeding from upper part of digestive tract in 3 cases, acute or subacute intestinal obstruction in 2 cases. The period of time between the L. Ch. and a reoperation was 2 weeks up to 2 months in patients with tumor of large or small bowel, 1 month up to 1 year in patients with head of pancreas carcinoma and 2 months up to 14 months in patients with stomach neoplasma. None of the patients complained about symptoms of neoplastic illness before the L. Ch. Small, deeply located or unapproachable for the examination tumors of an abdominal cavity might be easily overlooked during L. Ch. CONCLUSIONS: 1. Perhaps better anamnesis and more extensive diagnostic procedures (G. endoscopy, ERCP, CT) might have caused earlier discovery of the malignancies in some of these patients. 2. During laparoscopic control of abdomen cavity overlooking of neoplastic illness, particularly in patients aged over 40 is possible.