PITFALLS IN LAPAROSCOPIC CHOLECYSTECTOMY - UNRECOGNIZED CARCINOMA OF ANOTHER SITE

Laparoscopic cholecystectomy has been rapidly adopted as a standard su rgical treatment in symptomatic cholelithiasis. Its advantages over la parotomy are well described. However, its risks and long-term results have not been fully evaluated. We experienced three patients in whom i ntra-abdominal carcinomas failed to be recognized during laparoscopic surgery. The clinical manifestations, laboratory findings, and radiolo gic findings were carefully reviewed in each case. Limited exploration of the abdominal cavity is one of the technical pitfalls in laparosco pic cholecystectomy; so surgeons can miss the carcinoma of extrabiliar y system. To prevent such problems, a careful taking of the history an d physical examination should be repeated by the responsible surgeon, who must be aware of the differential diagnosis of cholelithiasis, esp ecially in elderly patients. If needed, additional radiologic studies are recommended.