Original CommunicationsIncidence of port site recurrence after laparoscopic cholecystectomy for preoperatively unsuspected gallbladder carcinoma☆
Section snippets
Patients and methods
The Swiss Association of Laparoscopic and Thoracoscopic Surgery (SALTS) conducted a prospective 3-year study on laparoscopic cholecystectomy from 1992 to 1995. Eighty-two surgical institutions in Switzerland participated in this study. These surgical units performed approximately 50% of all cholecystectomies in Switzerland during the same period. All patients undergoing laparoscopic cholecystectomy in 1 of the participating surgical departments were enrolled in this study. Data were collected
Patients and indications
Thirty-nine of 10,925 patients who had undergone attempted or completed laparoscopic cholecystectomy had histologically malignant lesions of the gallbladder. Adenocarcinomas were found in 37 of 39 patients; 1 patient had a small cell carcinoma and 1 patient had a carcinoid tumor of the cystic duct. These last 2 patients were not included in our study. The female/male ratio in the 37 patients with adenocarcinoma of the gallbladder was 3.6:1 (29:8). The mean age was 67 years (range 51 to 87
Discussion
Port site recurrences after laparoscopic operations have changed the spectrum of presentation of metastatic gallbladder carcinomas. A preoperatively undiagnosed gallbladder carcinoma is a rare event (0.34%), and little is known about the incidence of port site recurrences after laparoscopic cholecystectomy in these patients.10 The literature suggests that incisional recurrences are more frequent after laparoscopic operation than after open procedures, and patients with gallbladder cancer
Acknowledgements
We and SALTS thank Mrs Franziska Rieben for her relentless effort in the centralized data collection, the Arbeitsgemeinschaft für Osteosynthesefragen in Davos, in particular Martin Buehler, for support in the computer analysis, and Dr Ramon E. Jimenez for reading, correcting, and improving the manuscript. Thanks also go to the following fellow surgeons of the SALTS and their supporting staff, and residents who contributed to this study: Kantonsspital Aarau (P. Aeberhard), Spital Aarberg (C.
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Reprint requests: K. Z'graggen, MD, Department of Visceral and Transplantation Surgery, Inselspital, University of Bern, Murtenstrasse, CH-3010 Bern, Switzerland.