Research Article
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Laparoskopik Kolesistektomi Yapılan Hastalarda Rastlantısal Safra Kesesi Kanseri Sıklığı

Year 2023, Volume: 20 Issue: 3, 593 - 598, 31.12.2023
https://doi.org/10.35440/hutfd.1328672

Abstract

Amaç: Safra kesesi kanserleri nadir görülen ve tanısı patolojik inceleme ile konulabilen hastalıklardır. Bu çalışmada laparoskopik kolesistektomi yapılan hastalarda rastlantısal safra kesesi kanseri sıklığımızı saptayarak "safra kesesi kanseri insidansını azaltmak için safra kesesi hastalıklarında kolesistektomi endikasyonlarını genişletmeli miyiz?" sorusuna cevap bulmayı amaçladık.
Materyal ve metod: Ocak 2011- Ocak 2023 tarihleri arasında kolesistektomi yapılan hastaların dosyala-rını geriye dönük olarak incelendi. 18 yaş altı , açık kolesistektomi yapılan, ameliyat öncesi tanı alan ve eş zamanlı farklı onkolojik hastalık taşıyan hastalar çalışma dışında bırakıldı. Safra kesesi hastalığı nedeniyle laparoskopik kolesistektomi yapılan 18 yaş üstü hastalar çalışmaya dahil edildi. Rastlantısal olarak safra kesesi kanseri saptanan hastaların demografik verileri, radyolojik incelemeleri, patoloji raporları, evreleri, takip ve tedavi sonuçları kaydedildi.
Bulgular: Belirlenen tarih aralığında kolesistektomi yapılan 4499 hastanın 3324’ü çalışmaya dahil edilme kriterlerini karşılıyordu. Dokuz (%0.27) hastada rastlantısal olarak safra kesesi kanseri tespit edildi. Hastaların 5(%55.5)’i erkekti (E/K:5/4) ve yaş ortalamaları 67.3 (47-78) yıldı. Beş hastaya sadece laparoskopik kolesistektomi yapılırken dört hastaya kolesistektomi sonrasında geniş rezeksiyon sonrası adjuvan kemoterapi verildi. Mortalite oranı %55.5 (n=5)’di.
Sonuç: Safra kesesi kanserlerinde erken evrede yakalanan hastalarda neticeler yüz güldürücüdür. Rastlantısal kanser olasılığı nedeniyle radyolojik inceleme ve histopatolojik değerlendirme itina ile yapılmalıdır. Erken yaşta tanı alan benign hastalıklarda semptomatik olmasa dahi yapılacak erken cerrahi tercihi kanser insidansını azaltabilir.

Supporting Institution

Başkent Üniversitesi

Project Number

KA21-389

References

  • 1. Jemal A, Tiwari RC, Murray T, Ghafoor A, Samuels A, Ward E, et al. Cancer statistics, 2004. CA Cancer J Clin 2004; 54: 8-29.
  • 2. Misra S, Chaturvedi A, Misra NC. Carcinoma of the gallblad-der. Lancet Oncol. 2003;4:167-76.
  • 3. Murthy NS, Rajaram D, Gautham M, Shivraj N, Pruthvish S, George PS, et al. Trends in incidence of gallbladder cancer – Indian scenario. Gastrointest Cancer 2011;1:1-9.
  • 4. Ahn Y, Park CS, Hwang S. Incidental gallbladder cancer after routine cholecystectomy: when should we suspect it preope-ratively and what are predictors of patient survival? Ann Surg Treat Res. 2016;90:131-38.
  • 5. Gourgiotis S, Kocher HM, Solaini L, Yarollahi A, Tsiambas E, Salemis NS. Gallbladder cancer. Am J Surg. 2008;196(2):252-64.
  • 6. Yamamoto H, Hayakawa N, Kitagawa Y, Katohno Y, Sasaya T, Takara D, et al. Unsuspected gallbladder carcinoma after laparoscopic cholecystectomy. J Hepatobiliary Pancreat Surg. 2005; 12: 391-98.
  • 7. Kwon AH, Imamura A, Kitade H. Unsuspected gallbladder cancer diagnosed during or after laparoscopic cholecystec-tomy. J Surg Oncol. 2008; 97: 241-45.
  • 8. Varshney S, Buttirini G, Gupta R. Incidental carcinoma of the gallbladder. Eur J Surg Oncol. 2002; 28: 4-10.
  • 9. Zhang WJ, Xu GF, Zou XP, Wang WB, Yu JC, Wu GZ, et al. Incidental gallbladder carcinoma diagnosed during or after laparoscopic cholecystectomy. World J Surg. 2009;33(12):2651-56.
  • 10. Jha V, Sharma P, Mandal KA. Incidental gallbladder carcino-ma:Utility of histopathological evaluation of routine cho-lecystectomy specimens. South Asian J Cancer. 2018 Jan-Mar;7(1):21-23.
  • 11. Tatli F, Ozgönül A, Yucel Y, Yalcin HC, Ciftci R, Gümer M ve ark. Incidental gallbladder cancer at cholecystectomy. Ann Ital Chir.2017;6:399-402.
  • 12. Gutt C, Schläfer S, Lammert F. The Treatment of Gallstone Disease. Dtsch Arztebl Int. 2020;117(9):148-158.
  • 13. Sung YN, Song M, Lee JH, Song KB, Hwang DW, Ahn CS, et al. Validation of the 8th Edition of the American Joint Com-mittee on Cancer Staging System for Gallbladder Cancer and Implications for the Follow-up of Patients without Node Dis-section. Cancer Res Treat. 2020;52(2):455-68.
  • 14. Albores-Saavedra J, Kloppel G, Adsay NV, Sripa B, Crawford JM, Tsui WMS et al. Carcinoma of the gallbladder and extra-hepatic bile ducts In: Bosman FT, Carneiro F, Hruban RH, Theise ND, editors. WHO Classification of Tumors of the Di-gestive System. 4th ed. Lyon:IARC Press, 2010:266-73.
  • 15. Pitt SC, Jin LX, Hall BL. Incidental gallbladder cancer at cho-lecystectomy: When should the surgeon be suspicious? Ann Surg. 2014;260:128-33.
  • 16. Engeland A, Tretli S, Austad G, Bjørge, T. Height and Body Mass Index in Relation to Colorectal and Gallbladder Cancer in Two Million Norwegian Men and Women. Cancer Causes & Control.2005:16(8);987-96.
  • 17. Ishiguro S, Inoue M, Kurahashi N, Iwasaki M, Sasazuki S,Tsugane S. Risk factors of biliary tract cancer in a large-scale population-based cohort study in Japan (JPHC study); with special focus on cholelithiasis, body mass index, and their effect modification. Cancer Causes Control 2008: 19; 33–41.
  • 18. Hsing, A.W, Sakoda, L.C, Rashid, A, Chen J, Shen MC, Han TQ, et al. Body size and the risk of biliary tract cancer: A po-pulation-based study in China. Br. J. Cancer 2008, 99, 811–15.
  • 19. Li ZM, Wu ZX, Han B, Mao YQ, Chen HL, Han SF, et al. The association between BMI and gallbladder cancer risk: a me-ta-analysis. Oncotarget. 2016;7(28):43669-79.
  • 20. Campbell PT, Newton CC, Kitahara CM, Patel AV, Hartge P, Koshiol J, et al. Body Size Indicators and Risk of Gallbladder Cancer: Pooled Analysis of Individual-Level Data from 19 Prospective Cohort Studies. Cancer Epidemiol Biomarkers Prev. 2017;26(4):597-606.
  • 21. Strom BL, Soloway RD, Rios-Dalenz JL, Rodriguez-Martinez HA, West SL, Kinman JL, et al. Risk factors for gallbladder cancer. An international collaborative case-control study. Cancer 1995; 76: 1747– 56.
  • 22. Panebianco A, Volpi A, Lozito C. Incidental gallbladder carci-noma: our experience. G Chir 2013;34:167-69.
  • 23. Lowenfels AB, Walker AM, Althaus DP, Townsend G, Domel-löf L. Gallstone growth, size, and risk of gallbladder cancer: an interracial study. Int J Epidemiol. 1989;18(1):50-4.
  • 24. Vitetta L, Sali A, Little P, Mrazek L. Gallstones and gall blad-der carcinoma. Aust N Z J Surg. 2000;70(9):667-73.
  • 25. Moerman CJ, Bueno-de-Mesquita HB. The epidemiology of gallbladder cancer: lifestyle related risk factors and limited surgical possibilities for prevention. Hepatogastroenterology. 1999;46(27):1533-39.
  • 26. Tazuma S, Kajiyama G. Carcinogenesis of malignant lesions of the gall bladder. The impact of chronic inflammation and gallstones. Langenbecks Arch Surg. 2001;386:224–29.
  • 27. Duarte I, Llanos O, Domke H. Metaplasia and precursor lesions of gallbladder carcinoma. Frequency, distribution, and probability of detection in routine histologic samples. Cancer. 1993;72:1878–84.
  • 28. Zatonski WA, Lowenfels AB, Boyle P, Maisonneuve P, Bueno de Mesquita HB, Ghadirian P, et al. Epidemiologic aspects of gallbladder cancer: a case control study of the SEARCH Prog-ram of the international Agency for Research on cancerJ Natl Cancer Inst, 1997;89:1132-38.
  • 29. Serra I, Yamamoto M, Calvo A, Cavada G, Báez S, Endoh K, et al.Association of chilli pepper consumption, low socioeco-nomic status and longstanding gallstones with gallbladder cancer in a Chilean population Int J Cancer, 2002;102: 407-11.
  • 30. Yeh CN, Jan YY, Chao TC. Laparoscopic cholecystectomy for polypoid lesions of the gallbladder: a clinicopathologic study. Surg Laparosc Endosc Percutan Tech 2001;11:176–81.
  • 31. Sujata J, S R, Sabina K, Mj H. Incidental gallbladder carcino-ma in laparoscopic cholecystectomy: a report of 6 cases and a review of the literature. J Clin Diagn Res 2013;7:85–8.
  • 32. Yadav R, Sagar M, Kumar S. Incidental Gallbladder Carcino-ma in North Indian Population: Importance of Routine Histo-pathological Examination of All Benign Gallbladder Speci-mens. Cureus. 2021;13(7).
  • 33. Muratore A, Polastri R, Bouzari H, Vergara V, Capussotti L. Radical surgery for gallbladder cancer: a worthwhile opera-tion?. Eur J Surg Oncol. 2000;26(2):160-63.
  • 34. Lv TR, Yang C, Regmi P, Ma, WJ, Hu HJ, Liu F, et al. The role of laparoscopic surgery in the surgical management of gallb-ladder carcinoma: A systematic review and meta-analysis. Asian J Surg. 2021;44(12):1493-502.
  • 35. Zhang WJ, Xu GF, Zou XP, Wang WB, Yu JC, Wu GZ, et al. Incidental gallbladder carcinoma diagnosed during or after laparoscopic cholecystectomy. World J Surg. 2009;33:2651–56.
  • 36. Nakeeb A, Tran KQ, Black MJ, Erickson BA, Ritch PS, Queb-beman EJ, et al. Improved survival in resected biliary malig-nancies. Surg, 2002;132:555–64.
  • 37. Cavallaro A, Piccolo G, Panebianco V, Lo Menzo E, Berretta M, Zanghì A, et al. Incidental gallbladder cancer during lapa-roscopic cholecystectomy: managing an unexpected finding. World J Gastroenterol. 2012;18(30):4019-27.
  • 38. Dr Rachael Liebmann, Dr Murali Varma. Royal College of Pathologists. 2th Edition, Histopathology and Cytopathology of Limited or No Clinical Value, in Report of Working Group of the Royal College of Pathologists, London 2005.
  • 39. Schmidt MA, Marcano-Bonilla L, Roberts LR. Gallbladder cancer: epidemiology and genetic risk associations. Chin Clin Oncol. 2019;8(4):31.

The Frequency of Incidental Gallbladder Cancer in Patients Undergoing Laparoscopic Cholecystectomy

Year 2023, Volume: 20 Issue: 3, 593 - 598, 31.12.2023
https://doi.org/10.35440/hutfd.1328672

Abstract

Background: Gallbladder cancers are rare diseases that can be diagnosed by pathological examination. In this study, we determined the frequency of incidental gallbladder cancer in patients who under-went laparoscopic cholecystectomy and asked, "Should we expand the indications for cholecystecto-my in in gallbladder diseases to reduce the incidence of gallbladder cancer?" We aimed to find an answer to the question.
Materials and Methods: The files of patients who underwent cholecystectomy between January 2011 and January 2023 were reviewed retrospectively. Patients under the age of 18 who underwent open cholecystectomy, were diagnosed preoperatively and had different concomitant oncological diseases were excluded from the study. Patients over the age of 18 who underwent laparoscopic cholecystec-tomy for benign gallbladder disease were included in the study. Demographic data, radiological examinations, pathology reports, stages, follow-up and treatment, and results of patients with inci-dentally diagnosed gallbladder cancer were recorded.
Results: Of the 4499 patients who underwent cholecystectomy within the specified date range, 3324 met the inclusion criteria. Gallbladder cancer was detected incidentally in nine (0.27%) patients. 5 (55.5%) of the patients were male (M/F:5/4) and their mean age was 67.3 (47-78) years. While five patients underwent only laparoscopic cholecystectomy, four patients received adjuvant chemothe-rapy after extensive resection after cholecystectomy. The mortality rate was 55.5% (n=5).
Conclusions: The results are satisfactory in patients with gallbladder cancers diagnosed at an early stage. Because of the possibility of coincidental cancer, radiological examination and histopathologi-cal evaluation should be done with care. Even if it is not symptomatic, the choice of early surgery in benign diseases diagnosed at an early age should be reviewed with new studies.

Ethical Statement

Başkent Üniversitesi Tıp ve Sağlık Bilimleri Etik Kurulu tarafından onaylanmış (tarih: 03/ 08/ 2022; no: KA/21389) ve Helsinki Deklarasyonuna uygun olarak dizayn edilmiştir.

Project Number

KA21-389

References

  • 1. Jemal A, Tiwari RC, Murray T, Ghafoor A, Samuels A, Ward E, et al. Cancer statistics, 2004. CA Cancer J Clin 2004; 54: 8-29.
  • 2. Misra S, Chaturvedi A, Misra NC. Carcinoma of the gallblad-der. Lancet Oncol. 2003;4:167-76.
  • 3. Murthy NS, Rajaram D, Gautham M, Shivraj N, Pruthvish S, George PS, et al. Trends in incidence of gallbladder cancer – Indian scenario. Gastrointest Cancer 2011;1:1-9.
  • 4. Ahn Y, Park CS, Hwang S. Incidental gallbladder cancer after routine cholecystectomy: when should we suspect it preope-ratively and what are predictors of patient survival? Ann Surg Treat Res. 2016;90:131-38.
  • 5. Gourgiotis S, Kocher HM, Solaini L, Yarollahi A, Tsiambas E, Salemis NS. Gallbladder cancer. Am J Surg. 2008;196(2):252-64.
  • 6. Yamamoto H, Hayakawa N, Kitagawa Y, Katohno Y, Sasaya T, Takara D, et al. Unsuspected gallbladder carcinoma after laparoscopic cholecystectomy. J Hepatobiliary Pancreat Surg. 2005; 12: 391-98.
  • 7. Kwon AH, Imamura A, Kitade H. Unsuspected gallbladder cancer diagnosed during or after laparoscopic cholecystec-tomy. J Surg Oncol. 2008; 97: 241-45.
  • 8. Varshney S, Buttirini G, Gupta R. Incidental carcinoma of the gallbladder. Eur J Surg Oncol. 2002; 28: 4-10.
  • 9. Zhang WJ, Xu GF, Zou XP, Wang WB, Yu JC, Wu GZ, et al. Incidental gallbladder carcinoma diagnosed during or after laparoscopic cholecystectomy. World J Surg. 2009;33(12):2651-56.
  • 10. Jha V, Sharma P, Mandal KA. Incidental gallbladder carcino-ma:Utility of histopathological evaluation of routine cho-lecystectomy specimens. South Asian J Cancer. 2018 Jan-Mar;7(1):21-23.
  • 11. Tatli F, Ozgönül A, Yucel Y, Yalcin HC, Ciftci R, Gümer M ve ark. Incidental gallbladder cancer at cholecystectomy. Ann Ital Chir.2017;6:399-402.
  • 12. Gutt C, Schläfer S, Lammert F. The Treatment of Gallstone Disease. Dtsch Arztebl Int. 2020;117(9):148-158.
  • 13. Sung YN, Song M, Lee JH, Song KB, Hwang DW, Ahn CS, et al. Validation of the 8th Edition of the American Joint Com-mittee on Cancer Staging System for Gallbladder Cancer and Implications for the Follow-up of Patients without Node Dis-section. Cancer Res Treat. 2020;52(2):455-68.
  • 14. Albores-Saavedra J, Kloppel G, Adsay NV, Sripa B, Crawford JM, Tsui WMS et al. Carcinoma of the gallbladder and extra-hepatic bile ducts In: Bosman FT, Carneiro F, Hruban RH, Theise ND, editors. WHO Classification of Tumors of the Di-gestive System. 4th ed. Lyon:IARC Press, 2010:266-73.
  • 15. Pitt SC, Jin LX, Hall BL. Incidental gallbladder cancer at cho-lecystectomy: When should the surgeon be suspicious? Ann Surg. 2014;260:128-33.
  • 16. Engeland A, Tretli S, Austad G, Bjørge, T. Height and Body Mass Index in Relation to Colorectal and Gallbladder Cancer in Two Million Norwegian Men and Women. Cancer Causes & Control.2005:16(8);987-96.
  • 17. Ishiguro S, Inoue M, Kurahashi N, Iwasaki M, Sasazuki S,Tsugane S. Risk factors of biliary tract cancer in a large-scale population-based cohort study in Japan (JPHC study); with special focus on cholelithiasis, body mass index, and their effect modification. Cancer Causes Control 2008: 19; 33–41.
  • 18. Hsing, A.W, Sakoda, L.C, Rashid, A, Chen J, Shen MC, Han TQ, et al. Body size and the risk of biliary tract cancer: A po-pulation-based study in China. Br. J. Cancer 2008, 99, 811–15.
  • 19. Li ZM, Wu ZX, Han B, Mao YQ, Chen HL, Han SF, et al. The association between BMI and gallbladder cancer risk: a me-ta-analysis. Oncotarget. 2016;7(28):43669-79.
  • 20. Campbell PT, Newton CC, Kitahara CM, Patel AV, Hartge P, Koshiol J, et al. Body Size Indicators and Risk of Gallbladder Cancer: Pooled Analysis of Individual-Level Data from 19 Prospective Cohort Studies. Cancer Epidemiol Biomarkers Prev. 2017;26(4):597-606.
  • 21. Strom BL, Soloway RD, Rios-Dalenz JL, Rodriguez-Martinez HA, West SL, Kinman JL, et al. Risk factors for gallbladder cancer. An international collaborative case-control study. Cancer 1995; 76: 1747– 56.
  • 22. Panebianco A, Volpi A, Lozito C. Incidental gallbladder carci-noma: our experience. G Chir 2013;34:167-69.
  • 23. Lowenfels AB, Walker AM, Althaus DP, Townsend G, Domel-löf L. Gallstone growth, size, and risk of gallbladder cancer: an interracial study. Int J Epidemiol. 1989;18(1):50-4.
  • 24. Vitetta L, Sali A, Little P, Mrazek L. Gallstones and gall blad-der carcinoma. Aust N Z J Surg. 2000;70(9):667-73.
  • 25. Moerman CJ, Bueno-de-Mesquita HB. The epidemiology of gallbladder cancer: lifestyle related risk factors and limited surgical possibilities for prevention. Hepatogastroenterology. 1999;46(27):1533-39.
  • 26. Tazuma S, Kajiyama G. Carcinogenesis of malignant lesions of the gall bladder. The impact of chronic inflammation and gallstones. Langenbecks Arch Surg. 2001;386:224–29.
  • 27. Duarte I, Llanos O, Domke H. Metaplasia and precursor lesions of gallbladder carcinoma. Frequency, distribution, and probability of detection in routine histologic samples. Cancer. 1993;72:1878–84.
  • 28. Zatonski WA, Lowenfels AB, Boyle P, Maisonneuve P, Bueno de Mesquita HB, Ghadirian P, et al. Epidemiologic aspects of gallbladder cancer: a case control study of the SEARCH Prog-ram of the international Agency for Research on cancerJ Natl Cancer Inst, 1997;89:1132-38.
  • 29. Serra I, Yamamoto M, Calvo A, Cavada G, Báez S, Endoh K, et al.Association of chilli pepper consumption, low socioeco-nomic status and longstanding gallstones with gallbladder cancer in a Chilean population Int J Cancer, 2002;102: 407-11.
  • 30. Yeh CN, Jan YY, Chao TC. Laparoscopic cholecystectomy for polypoid lesions of the gallbladder: a clinicopathologic study. Surg Laparosc Endosc Percutan Tech 2001;11:176–81.
  • 31. Sujata J, S R, Sabina K, Mj H. Incidental gallbladder carcino-ma in laparoscopic cholecystectomy: a report of 6 cases and a review of the literature. J Clin Diagn Res 2013;7:85–8.
  • 32. Yadav R, Sagar M, Kumar S. Incidental Gallbladder Carcino-ma in North Indian Population: Importance of Routine Histo-pathological Examination of All Benign Gallbladder Speci-mens. Cureus. 2021;13(7).
  • 33. Muratore A, Polastri R, Bouzari H, Vergara V, Capussotti L. Radical surgery for gallbladder cancer: a worthwhile opera-tion?. Eur J Surg Oncol. 2000;26(2):160-63.
  • 34. Lv TR, Yang C, Regmi P, Ma, WJ, Hu HJ, Liu F, et al. The role of laparoscopic surgery in the surgical management of gallb-ladder carcinoma: A systematic review and meta-analysis. Asian J Surg. 2021;44(12):1493-502.
  • 35. Zhang WJ, Xu GF, Zou XP, Wang WB, Yu JC, Wu GZ, et al. Incidental gallbladder carcinoma diagnosed during or after laparoscopic cholecystectomy. World J Surg. 2009;33:2651–56.
  • 36. Nakeeb A, Tran KQ, Black MJ, Erickson BA, Ritch PS, Queb-beman EJ, et al. Improved survival in resected biliary malig-nancies. Surg, 2002;132:555–64.
  • 37. Cavallaro A, Piccolo G, Panebianco V, Lo Menzo E, Berretta M, Zanghì A, et al. Incidental gallbladder cancer during lapa-roscopic cholecystectomy: managing an unexpected finding. World J Gastroenterol. 2012;18(30):4019-27.
  • 38. Dr Rachael Liebmann, Dr Murali Varma. Royal College of Pathologists. 2th Edition, Histopathology and Cytopathology of Limited or No Clinical Value, in Report of Working Group of the Royal College of Pathologists, London 2005.
  • 39. Schmidt MA, Marcano-Bonilla L, Roberts LR. Gallbladder cancer: epidemiology and genetic risk associations. Chin Clin Oncol. 2019;8(4):31.
There are 39 citations in total.

Details

Primary Language Turkish
Subjects General Surgery
Journal Section Research Article
Authors

Serkan Erkan 0000-0002-4981-5492

Hakan Yabanoğlu 0000-0002-1161-3369

Project Number KA21-389
Early Pub Date December 11, 2023
Publication Date December 31, 2023
Submission Date July 18, 2023
Acceptance Date December 2, 2023
Published in Issue Year 2023 Volume: 20 Issue: 3

Cite

Vancouver Erkan S, Yabanoğlu H. Laparoskopik Kolesistektomi Yapılan Hastalarda Rastlantısal Safra Kesesi Kanseri Sıklığı. Harran Üniversitesi Tıp Fakültesi Dergisi. 2023;20(3):593-8.

Harran Üniversitesi Tıp Fakültesi Dergisi  / Journal of Harran University Medical Faculty