Clinical analysis on re-operative patients with gallbladder cancer revealed by pathology examination after laparoscopic cholecystectomy / 重庆医学

ABSTRACT

Objective To investigate the treatment strategy for the re-operation patients with gallbladder cancer revealed by pathological results after laparoscopic cholecystectomy .Methods The clinical data in 15 cases of gallbladder cancer found by pa-thology after laparoscopic cholecystectomy in the general surgery department of this hospital during 2009-2013 were retrospective-ly analyzed .Results The pathological results on 3-5 d after laparoscopic cholecystectomy in 15 cases showed gallbladder cancer , tumor located at the gallbladder fundus in 2 cases ,the gallbladder body in 2 cases and gallbladder neck in 9 cases;there were 1 case of severe atypical hyperplasia ,2 cases of high differentiation adenocarcinoma ,9 cases of middle differentiation adenocarcinoma and 3 cases of low differentiation adenocarcinoma ;there were 1 case of Tis ,8 cases of pT Ⅰa ,6 cases of pTⅠb ,and 15 cases of bile tube incisal edge were negative .All 15 cases received re-laparotomy and hepatic duodenal ligament lymph nodes resection on 6-11 d af-ter cholecystectomy ,There were 1 case in the stage 0 ,8 cases in the stage Ⅰa ,5 cases in the stage Ⅰb ,1 case in the stage Ⅲb by TNM classification .The postoperative follow up lasted for 28 -79 months ,the accumulative survival rate was 100% in 1 year , 100% in 2 year ,93% in 3 year ,93% in 5 year .One case of stage Ⅲb was found repeated metastasis obstructive jaundice ,received transcutaneous puncture bile tract drainage and died after 3 months;no postoperative incision implantation metastasis was found . Conclusion Gallbladder cancer found by pathological examination after laparoscopic cholecystectomy is generally in early stage . Therefore ,early conducting the additional hepatic duodenal ligament lymphadenectomy has relatively good prognosis .