Unexpected gallbladder cancer during laparoscopic cholecystectomy
Unexpected gallbladder cancer during laparoscopic cholecystectomy
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DOI：
10.1007/s00534-004-0910-y
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发表时间：
2004-01-01
期刊：
影响因子：
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通讯作者：
Tatlicioglu, E
中科院分区：
文献类型：
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作者：
Akyürek, N;Irkörucü, O;Tatlicioglu, E
背景目的。在本研究中，我们调查了外科医生在腹腔镜胆囊切除术（LC）中确定偶然胆囊病变的有效性。方法。这项研究纳入了 2001 年 5 月 1 日至 2003 年 10 月 15 日期间接受 LC 的 548 名胆结石患者。外科医生在胆囊壁上切开一个切口进行检查，并在从腹腔取出胆囊后触诊粘膜，以寻找未怀疑的病变。如果观察或触诊粘膜异常，则用丝线缝合标记，然后进行组织病理学检查。结果。外科医生发现 548 份 LC 标本中的 50 份可疑。冰冻切片的组织病理学检查揭示了其中 15 个标本的偶然病理情况。引人注目的是，其中 5 个样本被认为患有胆囊癌 (GBC)。其他偶发病理与子宫腺肌瘤病、黄色肉芽肿性胆囊炎、纤维上皮性息肉和增生性息肉一致。其他 498 个标本中的 4 个在最终的组织病理学检查中显示出偶然的病理，并且所有这些都与胃上皮化生一致。该方法的敏感性和特异性分别为 78.9% 和 93%。结论。一个简单的程序；也就是说，胆囊的切开、检查和触诊似乎有助于诊断偶发性胆囊病变。
Background purpose. In the present study, we investigated the effectiveness of surgeons in determining incidental gallbladder pathologies at laparoscopic cholecystectomy (LC).Methods. This study included 548 patients with gallstones who underwent LC between May 1, 2001 and October 15, 2003. The surgeon made an incision on the gallbladder wall for inspection, and palpated the mucosa after removing the gallbladder from the abdominal cavity to look for unsuspected pathologies. If an abnormal mucosa was observed or palpated, it was marked with a silk suture and then histopathologic examination was performed.Results. Fifty of 548 LC specimens were found to be suspicious by the surgeon. Histopathological examination of frozen sections revealed incidental pathologies in 15 of these specimens. Strikingly, 5 of these specimens were considered to have gallbladder cancer (GBC). The other incidental pathologies were consistent with adenomyomatosis, xanthogranulomatous cholecystitis, and fibroepithelial and hyperplastic polyps. Four of the other 498 specimens revealed incidental pathologies at definitive histopathological examination, and all of them were consistent with gastric metaplasia. The sensitivity and specificity of the procedure was 78.9% and 93%, respectively.Conclusions. A simple procedure; that is, incision and inspection, and palpation of the gallbladder, seems to be useful for the diagnosis of incidental gallbladder pathologies.