DELAYED DIAGNOSIS OF MALIGNANT-TUMORS MISSED AT LAPAROSCOPIC CHOLECYSTECTOMY

Background: The aim of this study was to compare the significance of r outine examinations prior to laparoscopic cholecystectomy (LC) with in traoperative abdominal investigation. Preoperative evaluation becomes increasingly important when laparoscopic procedures are performed for the removal of gallstones because other intraabdominal diseases may co exist in these patients, mimicking biliary tract disease. Methods: Ove r the last 6 years, we treated 816 patients with symptomatic cholecyst olithiasis using LC. Prior to surgery, routine tests such as upper abd ominal ultrasonography, chest radiography, and standard laboratory blo od tests were carried out. Results: Despite these routine tests, coexi sting colonic cancers escaped detection in four out of 816 cases. This indicates a risk of more ''missed pathologies'' during the course of laparoscopic operations compared to standard laparotomy. Conclusion: T he risk of missing coexisting diseases during laparoscopic operations has to be minimized by placing additional emphasis on careful evaluati on of anamnesis. Physical examination and additional laboratory tests- such as analysis of tumor markers and blood in the stool-combined with complete abdominal ultrasonography, gas troscopy, and/or complete col onoscopy should be performed prior to LC.