담낭 용종으로 복강경 수술 후 진단된 담낭암의 임상적 특성

Abstract

(Purpose) A laparoscopic cholecystectomy(LC) has been accepted as one of the methods of treatment for patients with gallbladder(GB) disease. It is possible to diagnosis of gallbladder malignant disease by radiologic finding, but some cases can be diagnosed as cancer of GB incidentally after a LC. GB cancer has very poor prognosis, but make a complete recover by early detection and resection. This study was performed to find out incidence and clinical feature of incidentally GB cancer after LC. (Method) Analyzed retrospectively 10 patients diagnosed GB polyp before operation but diagnosed GB cancer incidentally after LC from January 1998 to February 2007. (Result) Out of the 124 case of GB polyp, incidentally GB cancer patients was 10 incidence rate was about 8%. Mean age was 60.9. Mean diameter of polyps was 1.1cm, 6 has pedunculated polyps, 4 has sessile polyps. 4 patients has GB stone diagnosed by radiologic study before operation. 4 patients was pT1a tumor (limited to mucosa) and 6 patients was pT2 (invaded perimuscular tissue) or pT3 (perforated serosa, directly invaded into liver). (Conclusion) Malignancy potency of GB polys was 7~30%. So surgeon always thought about possibility of malignancy and carefully observed resected GB and GB tissue was taken frozen section examination during surgery, if needed radical cholecystectomy was performed.