Diagnosis and treatment of cholelithiasis complicated with abdominal tumors:a report of 36 caseas / 中国普通外科杂志

ABSTRACT

Objective To study the causes of mis diagnosis and the experience of diagnosis and management for cholelithiasis complicated with abdominal tumors.Methods Clinical data of 36 cases of cholelithiasis complicated with abdominal tumors were analyzed retrospectively.Among them,24 were male,12 female.The age ranged from 48 to 82 year old.Each case was diagnosis as cholelithiasis and admitted to our hospital.Results In 36 patients,18 was diagnosed as complecated with abdominal tumors preoperatively;12 was diagnosed intraoperatively,while in 6 cases the tumor was misdiagmosed for 5 days to 3 months,finally the tumor was comfirmed by reoperation and pathology.Among the 36 cases,the tumors cluding 5 of carcinoma of gallbladder(13.9%),4 of cholangiocarcinoma(11.1%),3 of hepatoma(8.3%),6 of pancreatic carcinoma(16.7%),6 of gastric carcinoma(16.7%),7 of colon carcinoma(19.4%),2 of rectal carcinoma(5.5%).Of them,2 cases refused operation,2 cases underwent intervention operation,the others reseived operation.During primary operation,radical resection of the tumor and cholecystectomy and/or common bile duct(CBD) exploration was performed in 18 patients,palliation resection and cholecystectomy and/or CBD exploration performed in 4 patients,exploratory laparotomy performed in 4 patients,and only LC and/or CBD exploration performed in 6 patients.Of the latters,reoperation was performed 5 days to 3 months after primary operation.4 patients had tumor radical resection,1 had palliation resection,and 1 had interventional therapy.Conclusions Cholelithiasis may complicated with abdominal tumor,especially with digestive tract tumor.For cholelithiasis patient the history-taking need to be done carefully before operation.For the senile patient and the patient without typical symptoms or physical signs,the systems checking shoud be done carefully preoperatively,and abdominal cavity should be checked carefully intraoperatvely to find the tumor,which may exist in abdominal cavity.the patient with syndrome of post-cholecystectomy shoud be carefully followed up to avoid the mis diagnosis and mistreatment of the tumor.