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Paolucci, V.

doi:10.1007/s005340100022

Cited by 69 publications

(12 citation statements)

References 54 publications

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“…The incidence of port site metastases of gallbladder carcinomas following a laparoscopic cholecystectomy is 8-30%, after a mean period of 4-10 months [1,4,9].…”

Section: Discussionmentioning

confidence: 99%

“…Patients with stage T1b and T2 carcinomas have a fair prognosis when a radical cholecystectomy (resection of the gallbladder and liver segments IVb and V combined with regional lymph node dissection) is performed [2,3]. However, port site recurrences are relatively frequent following the laparoscopic resection of the gallbladder, independent of tumor stage [1,4]. Even for patients with an initially favorable low-stage tumor, port site recurrences are generally regarded as a stage IV disease with a short life expectancy [5].…”

Section: Introductionmentioning

confidence: 99%

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Axillary metastases after port site recurrences of gallbladder carcinoma: a case report

2020

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Background: Incidental gallbladder carcinoma is often discovered after elective laparoscopic cholecystectomy for cholecystitis or cholecystolithiasis. Port site recurrences may occur. Patients with port site metastases of gallbladder carcinoma have a poor prognosis. Case presentation: A 61-year-old man underwent an elective laparoscopic cholecystectomy because of cholecystitis and gallstones. Pathology revealed a gallbladder carcinoma. After referral to a tertiary center, radical reresection followed. Three years later, an epigastric port site recurrence emerged, partially fixed to the xiphoid process. A wide abdominal wall resection was performed, including part of the xiphoid process. Follow-up was continued with periodical imaging and standard blood work. Three years after resection of this port site metastasis, the patient presented with an occasionally painful mass in the left axilla. Pathology revealed the presence of an adenocarcinoma, most likely arising from the prior gallbladder carcinoma. Given the extensive dissemination and limited symptoms in the axillary node, we decided against a surgical intervention, instead of adopting a wait-and-see policy. Disease progression occurred within 1 year, and the patient was treated with palliative radiotherapy, followed by palliative chemotherapy. The patient died of metastatic disease approximately 6.5 years after the initial cholecystectomy. Conclusions: Port site recurrences of (incidental) gallbladder carcinoma occur after laparoscopic cholecystectomy, despite preventive perioperative measures. Patients with port site recurrences can develop axillary lymph node metastases, similar to other truncal malignancies. Surgical interventions should be limited.

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“…The incidence of port site metastases of gallbladder carcinomas following a laparoscopic cholecystectomy is 8-30%, after a mean period of 4-10 months [1,4,9].…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Axillary metastases after port site recurrences of gallbladder carcinoma: a case report

2020

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“…In particular, reports concerning port site recurrence and peritoneal dissemination of cancer cells [33–40] brought about a cautionary note about the use of laparoscopy in patients in whom GbC was suspected, making GbC a formal contraindication for laparoscopy. Additional reports correlated the occurrence of port sites and peritoneal implantation to the association of CO 2 pneumoperitoneum effect and imprecise handling of gallbladder during laparoscopy leading to accidental perforation of gall bladder [36, 40–42]. Port site and peritoneal recurrence may occur through direct and indirect implantation of tumor cells, during the laparoscopic procedure [43].…”

Section: Discussionmentioning

confidence: 99%

Current Role of Minimally Invasive Radical Cholecystectomy for Gallbladder Cancer

Zimmitti

Manzoni

Guerini

et al. 2016

Gastroenterology Research and Practice

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Background. For Tis and T1a gallbladder cancer (GbC), laparoscopic cholecystectomy can provide similar survival outcomes compared to open cholecystectomy. However, for patients affected by resectable T1b or more advanced GbC, open approach radical cholecystectomy (RC), consisting in gallbladder liver bed resection or segment 4b-5 bisegmentectomy, with locoregional lymphadenectomy, is considered the gold standard while minimally invasive RC (MiRC) is skeptically considered. Aim. To analyze current literature on perioperative and oncologic outcomes of MiRC for patients affected by GbC. Methods. A Medline review of published articles until June 2016 concerning MiRC for GbC was performed. Results. Data relevant for this review were presented in 13 articles, including 152 patients undergoing an attempt of MiRC for GbC. No randomized clinical trial was found. The approach was laparoscopic in 147 patients and robotic in five. Conversion was required in 15 (10%) patients. Postoperative complications rate was 10% with no mortality. Long-term survival outcomes were reported by 11 studies, two of them showing similar oncologic results when comparing MiRC with matched open RC. Conclusions. Although randomized clinical trials are still lacking and only descriptive studies reporting on limited number of patients are available, current literature seems suggesting that when performed at highly specialized centers, MiRC for GbC is safe and feasible and has oncologic outcomes comparable to open RC.

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“…Many articles have reported that even PLGs with a diameter >1.5 mm, a potential early-stage cancer, could still be resected by laparoscopic cholecystectomy with full-thickness dissection (24–26). The key issue with such surgery is to maintain the integrity of the gallbladder and protect the Trocar port in order to avoid the dissemination of the cancer in case the lesion is malignant (27,28). …”

Section: Discussionmentioning

confidence: 99%

Differences between images of large adenoma and protruding type of gallbladder carcinoma

Jin

Zhang

et al. 2013

Oncology Letters

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The aim of this study was to investigate the differences between images of large adenoma of the gallbladder and the protruding type carcinoma of the gallbladder. A retrospective study was performed on 130 patients who underwent cholecystectomy or biopsy for gallbladder polypoid lesions larger than 10 mm; among them, 20 patients were malignant and 110 patients were benign. Patients’ details including ultrasonography (US), computed tomography (CT) and magnetic resonance (MR) findings were analyzed. All patients whose lesions were >15 mm by US, had CT or MR scans to further determine the nature of the lesion; two patients who were suspected to have a malignant lesion due to their large tumor size were benign by histological examination. Distinct differences were found between large adenoma and protruding type of gallbladder carcinoma. There were distinct differences between adenomas and the protruding type gallbladder cancers, and there was a pathological basis for the differences. Benign tumors had a more homogeneous texture, had spaces between the tumor and the gallbladder wall and a relatively normal configuration of the gallbladder wall. Based on these findings, certain lesions could be definitively diagnosed as benign adenomas and could help in treatment strategy.

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Untitled

Cited by 69 publications

References 54 publications

Axillary metastases after port site recurrences of gallbladder carcinoma: a case report

Axillary metastases after port site recurrences of gallbladder carcinoma: a case report

Current Role of Minimally Invasive Radical Cholecystectomy for Gallbladder Cancer

Differences between images of large adenoma and protruding type of gallbladder carcinoma

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