Clinical Feature of Incidental Gallbladder Cancer Diagnosed after Laparoscopic Cholecystectomy due to Gallbladder Polyps

ABSTRACT

PURPOSE: Laparoscopic cholecystectomy (LC) has been accepted as one of the best methods for treatment of patients with gallbladder (GB) disease. Diagnosis of malignant gallbladder disease by radiologic finding is possible; however, some cases can be diagnosed incidentally as cancer of the gallbladder after a LC. Prognosis of GB cancer is very poor; however, a complete recovery can be achieved with early detection and resection. This study was performed in order to determine incidence and clinical features of incidentally detected GB cancer after LC. METHODS: A retrospective analysis of 10 Patients diagnosed as GB polyp prior to surgery, but diagnosed incidentally as GB cancer after LC from January 2002 to February 2011 was conducted. RESULTS: Of 124 cases of GB polyp, 10 patients were diagnosed as incidental GB cancer, with incidence rate of approximately 8%. Mean age was 60.9. Mean diameter of polyps was 1.1 cm, with six cases of pedunculated polyps, and four cases of sessile polyps. GB stones were diagnosed by radiologic study prior to surgery in four patients. Four patients had pT1a tumors (limited to mucosa) and six patients had pT2 (invaded perimuscular tissue) or pT3 (perforated serosa, direct invasion into liver). CONCLUSION: Malignancy potential of GB polyps was 8%. Surgeons should be aware of the possibility of malignancy and frozen section biopsy should be performed for examination of suspected GB tissue. If needed, radical cholecystectomy should be performed.