caa a22 4500 475791061 CHVBK 20180406123710.0 cr unu---uuuuu 170329e20001201xx s 000 0 eng 10.1007/s004230000177 doi (NATIONALLICENCE)springer-10.1007/s004230000177 How to proceed in patients with carcinoma detected after laparoscopic cholecystectomy [Elektronische Daten] [D. Frauenschuh, R. Greim, E. Kraas] Abstract.: Carcinoma of the gallbladder is a rare disease. Gallbladder carcinoma is detected in less than 1% of all gallstone operations. With the introduction of laparoscopic surgery and the higher acceptance of this technique, gallbladders are now removed much earlier than they used to be. With the increase of cholecystectomies, the diagnosis of unexpected gallbladder carcinoma became more frequent. We report on how to proceed in patients with a diagnosis of gallbladder carcinoma and discuss the additional problems that have arisen since laparoscopic cholecystectomy became established. From June 1990 to December 1999, we performed 6230 cholecystectomies in the surgical department of Moabit Hospital in Berlin. Of these, 42 (0.6%) were identified as carcinoma. There were 37 women and five men, and the mean age was 69years. In 16 patients (39%), there was a preoperative suspicion of malignancy. In 26 patients (61%), malignancy was suspected intraoperatively or diagnosed postoperatively after pathologic examination of the resected gallbladder. In these patients, an open repeat operation was necessary in seven cases to achieve an adequate curative resection and staging. This involved additional liver bed resection and lymph node dissection of the hepatoduodenal ligament. Abdominal wall (port site) recurrence in the absence of distant metastasis was present only in two patients. We recommend removal using a bag in all gallbladders with wall thickening, irregularities, or scleroatrophic calcified gallbladder area. In stage Tis or T1, laparoscopic cholecystectomy is sufficient. In stage T2 and T3, we perform a repeat operation with liver bed resection and lymphadenectomy. Springer-Verlag, 2000 Gallbladder carcinoma Cholecystectomy Laparoscopy nationallicence Frauenschuh D. Chirurgische Abteilung, Zentrum für Minimal-Invasive Chirurgie, Krankenhaus Moabit, Turmstr. 21, 10559 Berlin, Germany aut Greim R. Chirurgische Abteilung, Zentrum für Minimal-Invasive Chirurgie, Krankenhaus Moabit, Turmstr. 21, 10559 Berlin, Germany aut Kraas E. Chirurgische Abteilung, Zentrum für Minimal-Invasive Chirurgie, Krankenhaus Moabit, Turmstr. 21, 10559 Berlin, Germany aut https://doi.org/10.1007/s004230000177 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s004230000177 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Frauenschuh D. Chirurgische Abteilung, Zentrum für Minimal-Invasive Chirurgie, Krankenhaus Moabit, Turmstr. 21, 10559 Berlin, Germany aut NATIONALLICENCE 700 1- Greim R. Chirurgische Abteilung, Zentrum für Minimal-Invasive Chirurgie, Krankenhaus Moabit, Turmstr. 21, 10559 Berlin, Germany aut NATIONALLICENCE 700 1- Kraas E. Chirurgische Abteilung, Zentrum für Minimal-Invasive Chirurgie, Krankenhaus Moabit, Turmstr. 21, 10559 Berlin, Germany aut Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer