Abstract
Aim: Incidental gallbladder cancer (GBC) is a more and more frequent medical entity discovered on the specimen after a cholecystectomy. The aim of our study is to value the importance of cholecystectomy as last diagnostic step or surgical procedure to prevent invasive gallbladder cancer. Histologicalroutinary examination of surgical specimen could discover a lot of hidden gallbladder cancer. Material and methods: We collected data on patients treated with video laparoscopic cholecystectomy (VLC) for lithiasis, from January 2000 to December 2015. We selected 477 patients, who underwent VLC after a preoperative gallstones positive US, and who had histologic analysis of gallbladder specimens. Our outcomes were retrospectively analyzed and compared to international results for a global review. Results: VLC has been realized in all patients with a rate of conversion of 5%. In 4 of these patients (0.9%) was incidentally discovered a GBC during pathological exam of specimens. All the samples showed adenocarcinoma-type lesions. Discussion: The incidental finding of gallbladder cancer during VLC is a quite rare event; incidence goes from 0.2 to 2.9% (0.9% in our personal experience). Good results in term of overall survival were obtained for pTis and pT1a, while higher stages are related to a poor prognosis, especially in elderly population (due to comorbidities and less therapeutic choices). Most severe stages are related to an extremely high mortality rate. Conclusions: VLC has an important role in diagnosing and treating gallbladder cancer. Lesions Tis and T1a can be efficiently treated with the only VLC approach, while more severe stages require further procedures. For this reason, we suggest the importance of a preventive cholecystectomy in high risk patients, followed by histological examination in selected cases. Keywords: Gallbladder carcinoma; Lithiasis; Histological examination; Elective approach; Prevention; Videolaparoscopic cholecystectomy.
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