IDDF2018-ABS-0045 Incidental gall bladder cancer in laparoscopic cholecystectomy

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Abstract

Background

Carcinoma of the Gall Bladder (GBC) is the most common malignancy of the biliary tract and sixth most common gastrointesnal malignancy worldwide. Laparoscopic cholecystectomy has now become the most commonly performed major surgery worldwide, and an increasing number of pathological specimens are said to be showing incidental malignancy. The overall incidence is around 0.2%–2.9%.

Methods

A retrospective study was done by reviewing records of patients who underwent Laparoscopic cholecystectomy at our centre between 2012–2016 (5 years). A total of 2758 cases were included in the study. Their mode of presentation, duration of symptoms, pre-operative imaging, intraoperative findings and histopathological reports were analysed.

Results

A total of 6 cases of incidental GBC were identified. The overall incidence was around 0.2%. The mean age of the group was 60 years of which 4 were females and 2 were males. On pathological analysis, one patient had a background of acute cholecystitis, one had chronic cholecystitis, one had a polyp, and the remaining had unremarkable histology in the remainder of the gallbladder. The staging was T2N1M0 in two patients, T1bNM0 in two patients and T3N1M0 in two patients. In addition, about 11 cases of mild to moderate dysplasia were identified.

Conclusions

Early identification and curative resection still seem to be the best bet for a successful outcome in gallbladder cancer. Incidental gallbladder cancer should be suspected in elderly patients with thickened Gall Bladder. Imaging forms a very important component of preoperative diagnosis. Patients with T stage of T1b and above should be offered re-resection to give the advantage of improved survival.

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