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Incidence, management, and outcome of incidental gallbladder carcinoma: analysis of the database of the Swiss association of laparoscopic and thoracoscopic surgery.
[carcinoma of the gallbladder]
Little
is
known
about
the
long
-term
survival
of
patients
with
incidental
gallbladder
carcinoma
(
IGBC
)
.
The
role
of
radical
resection
for
this
disease
is
discussed
controversially
in
the
literature
.
We
present
the
long
-term
survival
and
the
results
of
re
-resection
versus
simple
cholecystectomy
of
the
database
of
the
Swiss
Association
for
Laparoscopic
and
Thoracoscopic
Surgery
(
SALTS
)
from
1994
to
2004
.
Eighty
-
nine
patients
with
histologically
confirmed
carcinoma
of
the
gallbladder
were
identified
out
of
30
,
960
patients
undergoing
laparoscopic
cholecystectomy
.
Sixty
-
nine
patients
were
included
in
our
study
.
Long
-term
survival
by
different
T
-
stage
and
comparison
of
patients
with
extended
resection
versus
simple
cholecystectomy
were
calculated
using
the
log-rank
test
.
The
time-
to
-event
data
are
demonstrated
by
Kaplan-
Meier
curves
.
T
he
overall
incidence
of
IGBC
in
patients
who
underwent
laparoscopic
cholecystectomy
was
0
.
28
%
(
89
of
30
,
960
)
.
Fifty
patients
underwent
simple
cholecystectomy
[
n
=
2
:
carcinoma
in
situ
(
CIS
)
;
n
=
2
:
pT
1
a
;
n
=
10
:
pT
1
b
;
n
=
23
:
pT
2
;
n
=
8
:
pT
3
;
n
=
5
:
pT
4
]
,
whereas
extended
resection
was
performed
in
19
cases
(
n
=
2
:
pT
1
b
;
n
=
11
:
pT
2
;
n
=
6
:
pT
3
)
.
The
comparison
of
simple
cholecystectomy
versus
extended
re
-resection
of
the
gallbladder
bed
and
regional
lymph
node
resections
showed
a
significant
benefit
in
overall
survival
for
the
pT
2
and
pT
3
group
(
p
<
0
.
05
)
.
The
pT
1
b
group
showed
no
significant
benefit
in
overall
survival
(
p
=
0
.
34
)
.
IGBC
has
a
low
incidence
(
0
.
28
%
)
.
We
present
a
large
study
of
patients
with
IGBC
,
comparing
the
overall
survival
by
different
histological
findings
.
We
observed
a
significant
benefit
for
the
group
with
pT
2
and
pT
3
.
Therefore
we
recommend
extended
resection
of
the
gallbladder
bed
and
the
regional
lymph
nodes
for
patient
with
incidental
histologically
confirmed
pT
2
and
pT
3
carcinoma
of
the
gallbladder
after
performance
of
laparoscopic
cholecystectomy
.
For
patients
with
pT
1
b
stage
no
recommendations
can
be
given
based
on
this
study
.
