A 10-year experience of unsuspected gallbladder cancer after laparoscopic cholecystectomy

Unsuspected gallbladder cancer after laparoscopic cholecystectomy (LC) is a cancer that was previously manipulated by laparoscopic technique. The reported incidence was 0.3-1% and became an emerging problem as the popularity of LC increased. Lack of reliable data could address the outcome of reresection or nortreresection patients and the standard management. This study reviewed a single center experience in managing unsuspected gallbladder cancer patients after LC between July 1, 1992 and July 1, 2000 who had at least 2 years of follow-up. There were 11 patients (0.6%) postoperatively diagnosed with gallbladder cancer after 1825 LCs. Group A included three patients (28%) with nontransmural invasion, group B included four patients (36%) who had transmural invasion without secondary surgical intervention, and group C included four patients (36%) with reresection. The perioperation parameters and strategies were collected and compared. A review of the literature was performed simultaneously, and we concluded that unsuspected gallbladder cancer with nontransmural invasion needs no further treatment; however, aggressive reresection is beneficial to transmural invasion cancer, and prevention of bile spillage during LC should be the goal of every surgeon.