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Clinical implication of bile spillage in patients undergoing laparoscopic cholecystectomy for gallbladder cancer.

Authors
Lee, JM; Kim, BW; Kim, WH; Wang, HJ; Kim, MW
Citation
The American surgeon, 77(6):697-701, 2011
Journal Title
The American surgeon
ISSN
0003-13481555-9823
Abstract
We determined the influence of bile spillage on recurrence and survival during laparoscopic cholecystectomy (LC) for gallbladder (GB) cancer. Among the 136 patients with GB cancer treated at Ajou University Hospital between 1994 and 2007, 28 underwent LC alone. We compared patients without bile spillage (bile spillage [-] group, n = 16) with patients who had bile spillage (bile spillage [+] group, n = 12). There was no statistical difference in stage between the groups. In the bile spillage (-) group, all patients underwent curative resection and there were two patients with locoregional recurrences and three patients with systemic recurrences. In the bile spillage (+) group, five patients underwent R1 resection and one patient underwent R2 resection and all eight recurrent patients had systemic recurrences. The disease-free survival and overall survival were shorter in the bile spillage (+) group (disease-free survival, 71.4 vs 20.9 months; P = 0.028; overall survival, 72.6 vs 25.8 months; P = 0.014). Bile spillage is likely to be an association with an incomplete resection and systemic recurrences. When GB cancer is suspected during LC, conversion to open surgery for preventing bile spillage and achieving curative resection should be considered.
MeSH terms
AdultAgedAged, 80 and over*BileCholecystectomy, Laparoscopic/*adverse effectsDisease-Free SurvivalFemaleGallbladder Neoplasms/mortality/pathology/*surgeryHumansMaleMiddle AgedNeoplasm MetastasisNeoplasm SeedingNeoplasm StagingRetrospective StudiesSurvival Analysis
PMID
21679636
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Surgery
AJOU Authors
이, 재명김, 봉완김, 욱환왕, 희정김, 명욱
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