Long‑term outcomes of incidental gallbladder carcinoma without additional resection: A single institution experiment

Abstract

Incidental gallbladder carcinoma (IGC), defined as unexpected malignancy identified in the surgical gallbladder specimen of a cholecystectomy performed for a benign diagnosis, can be difficult to suspect preoperatively. Furthermore, there are valid clinical reasons to defer reoperation for additional resection, particularly in elderly patients. The present study aimed to determine the long-term outcomes and prognostic factors associated with recurrence in patients with IGC. The medical records of 678 patients who underwent cholecystectomy at Toyooka Hospital between September 2011 and November 2017 were reviewed. The cases identified to be IGC were retrospectively analyzed to determine patient and histopathological characteristics, surgical details, long-term outcomes and factors associated with cancer recurrence. A total of 22 patients were diagnosed with gallbladder carcinoma following cholecystectomy by histopathological examination, and 12 of these were identified to be IGC. The median age was 80 years (range 70-89 years). Although 6 of the 12 patients with IGC had stage pT2 or pT3 tumors, only 1 patient underwent additional resection. Recurrence occurred in 3 of the 8 patients who did not undergo additional resection and were available for long-term follow-up. Recurrence was not associated with the extent of tumor invasion but may be associated with other histopathological findings, preoperative treatment history and risk factors for recurrence. Furthermore, long-term survival was observed in patients with pT2 and pT3 tumors who did not undergo additional resection. Recurrence was not associated with the extent of tumor invasion but may be associated with other histopathological findings, preoperative treatment history, and risk factors for recurrence. Furthermore, long-term survival was observed in patients with pT2 and pT3 tumors who did not undergo additional resection. Even if it is a progressive IGC case, appropriate preoperative treatment or cholecystectomy without persistence of the carcinoma cell, based on a preoperative image evaluation and a postoperative histopathological examination, may greatly influence the long-term prognosis of IGC.

Synchronous metastatic pure squamous cell carcinoma of the Gallbladder: A case report and review of literature

“…A significant benefit of re-resection of gallbladder bed and regional lymph nodes following incidental gallbladder cancer was observed, especially with pT2 and pT3 disease [10]. On the other hand, another study observed that in their 12 incidental gallbladder cancers, long term survival was achieved without additional resection even in pT2 and T3 disease [11]. In our case, the patient was metastatic by the time she returned for further follow up, so there was no indication for further surgical intervention.…”

Etiology, Clinical Presentations, and Short-Term Treatment Outcomes of Extrahepatic Obstructive Jaundice in South-Western Uganda

“…This was consistent with a Japanese study. 30 The bad prognosis can be explained by the age of the participants at admission, dispersal of tumor cells into the liver bed through the ducts of Luschka and peritoneal cavity, and recurrence from the cystic duct stump. However, another study showed a better prognosis as their treatment modality constituted aggressive curative resection including radical cholecystectomy together with right hepatectomy and bile duct reconstruction.…”

Incidental Gallbladder Carcinoma Diagnosed After Laparoscopic Cholecystectomy

“…Early GBCs have more favorable outcomes, but they do not have specific symptoms, so they are mostly discovered incidentally, usually on histopathological ex-amination of the gallbladder specimen after cholecystectomy is performed for a benign diagnosis. [1][2][3][4] Laparoscopic cholecystectomy (LC) is one of the most often performed general surgeries. Incidental gallbladder carcinoma (IGBC) is diagnosed in 0.3-2.9% of all cholecystectomies and accounts for the majority of detected GBCs.…”

“…Pathological examinations after cholecystectomy are essential in the diagnosis of GBC. [2][3][4] This study aims to evaluate the incidence, clinical characteristics, and prognostic features of IGBC diagnosed after LC for benign gallbladder disease in rural areas.…”