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복강경 담낭 절제술 후 발견된 담낭암

Other Titles
 Gallbladder Cancer Incidentally discovered after a Laparoscopic Cholecystectomy 
Authors
 김경식  ;  이우정  ;  김호근  ;  지훈상  ;  김병로 
Citation
 Journal of the Korean Society of Endoscopic & Laparoscopic Surgeons (대한내시경복강경외과학회지), Vol.1(2) : 85-93, 1998 
Journal Title
 Journal of the Korean Society of Endoscopic & Laparoscopic Surgeons (대한내시경복강경외과학회지) 
ISSN
 1738-7884 
Issue Date
1998
Keywords
Laparoscopic cholecystectomy ; Gallbladder carcinoma ; Unsuspected carcinoma
Abstract
A laparoscopic cholecystecotomy has been accepted as one of the methods of treatment for patients with gallbladder(GB) pathology. Occasionally some cases can be diagnosed as cancer of the gallbladder incidentally after a laparoscopic cholecystectomy. We did 855 laparoscopic cholecystectomies from September 1991 to July 1996 and found 9 GB cancer patients after the operation. Most of the patients with GB cancer have a poor prognosis, but recently there have been some reports with good prognoses in this group of patients. The incidence of incidental GB cancer in laparoscopically resected GB specimens was 1.1% (9/855). The age distribution was between 44 and 72 yrs. Among the 9 cancer patients, 6 patients were found to have a GB mass as a result of lthe preoperative ultrasound examination. Four patients had mucosa-confined cancer and did not undergo any further treatment. One patient had mucosaconfined cancer with a residual tumor in the cystic duct resection margin and underwent segmental resection of the liver (IVa & V) and segmental resection of lthe common bile duct, including dissection of the pericholedochal lymph node. The other four patients had advanced GB cancer with subserosal invasion. One patient underwent segmental resection of the liver (IVa & V) and segmental resection of the common bile duct, including dissection of the pericholedochal lymph node, and the other patient received a pericholedochal lymph node dissection only. The follow-up period ranged from 39 months to 3 months. Only one patient, who had mucosa-confined cancer with cystic duct invasion, died from lung metastasis with local recurrence of the midclavicular trocar site at 16 months after the laparoscopic cholecystectomy, but the other 8 patients have been doing well until now. We recommend a habit of opening the gallbladder, examining the gross pathologic features, and [performing a frozen-section examinationin patients where FB cancer is suspected. During that procedure, a carful isolation technique (careful dissection and delivery of the specimen in vinyl bag is vital) for preventing tumor implantation.
Files in This Item:
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
Yonsei Authors
Kim, Kyung Sik(김경식) ORCID logo https://orcid.org/0000-0001-9498-284X
Kim, Hogeun(김호근)
Lee, Woo Jung(이우정) ORCID logo https://orcid.org/0000-0001-9273-261X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/176777
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