演題抄録

一般口演

開催概要
開催回
第56回・2018年・横浜
 

当院における腹腔鏡下胆嚢摘出術後の潜在胆嚢癌の治療成績

演題番号 : O36-3

[筆頭演者]
演者)富丸 慶人:1 
[共同演者]
野口 幸蔵:1、長瀬 博次:1、浜部 敦史:1、荻野 崇之:1、広田 将司:1、大島 一輝:1、谷田 司:1、能浦 真吾:1、今村 博司:1、岩澤 卓:1、赤木 謙三:1、堂野 恵三:1

1:市立豊中病院・外科

 

PURPOSE: The aim of this study is to investigate oncological outcome of incidental gallbladder cancer (iGBC) diagnosed after laparoscopic cholecystectomy. PATIENTS AND METHODS: A total of 39 patients diagnosed with iGBC after laparoscopic cholecystectomy were enrolled in this study, and their oncological outcome was investigated. RESULTS: Preoperative diagnosis of the patients were as follows; gallbladder stone in 20 patients, gallbladder polyp in 8, cholecystitis in 9, and adenomyomatosis in 2. Depth of mural invasion of iGBC was M in 16 cases, MP in 3, SS in 16, and deeper than SS in 4. Among 19 M/MP cases, 1 case with positive margin refused additional resection and was followed-up without the resection. The remaining 18 cases with negative margin were followed-up and remained alive without recurrence. Additional resection was performed in 16 cases out of 20 cases with SS/deeper than SS. Intriguingly, peritoneal dissemination was identified at the additional resection in 1 case, who had intraoperative bile leak at the prior laparoscopic cholecystectomy. There was no significant difference in R2 resection rate between iGBC and non-iGBC with SS/deeper than SS. Prognosis of R0/R1 patients with SS/deeper than SS was not significantly different from that of patients with non-iGBC. Port-site recurrence was found in 2 cases. CONCLUSIONS: These results suggested that the treatment strategy for iGBC is acceptable. However, considering existence of the cases with peritoneal dissemination or port-site recurrence, possibility of iGBC existence should be kept in mind at the initial laparoscopic cholecystectomy.

キーワード

臓器別:胆嚢・胆道

手法別:手術療法

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