The patient was a 19-year-old male. He had inserted a pencil transanally at home, and it became difficult to remove, but he did not have any symptoms. The following day, however, he had lower abdominal pain and bloody stool, so he went to his local doctor. Abdominal X-ray and CT showed a rod-shaped structure in the sigmoid colon and upper rectum. Manual removal through the anus was difficult, so the structure was removed endoscopically. The patient was discharged from the hospital on the fourth postoperative day without any abdominal symptom exacerbation.
Background Whole-layer laparoscopic cholecystectomy (W-LC) has recently been advocated as a total biopsy for potentially malignant neoplasms of the gallbladder; however, it is not an injury-proof procedure. This study reports W-LC using the segment IV approach (technique for securing the whole-layer gallbladder at the medial origin of the cystic plate).MethodsTwenty among twenty-five patients diagnosed with potentially malignant gallbladder polyps underwent this technique.ResultsMostly, W-LC was performed successfully (median operative time 135 min) without intraoperative and postoperative complications. Pathological findings indicated that cholesteric polyps was the most common type (n=13), followed by adenomatous polyps (25%) and carcinoma in situ (5%).ConclusionsWe conclude that the segment IV approach is appropriate for performing total biopsy in patients diagnosed with potentially malignant gallbladder polyps.
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