LAPAROSCOPIC CANCER-SURGERY - LESSONS FROM GALLBLADDER CANCER

Laparoscopic cholecystectomy (LC) may inhibit the discovery of unsuspe cted gallbladder cancer, and the effect of LC on the prognosis of gall bladder cancer is unknown. We present two cases of unsuspected gallbla dder cancer removed laparoscopically and report the discovery of perit oneal tumor implantation at the umbilical port site 21 days after LC. Although gallbladder carcinoma flow cytometry has been reported to be of prognostic value by Japanese investigators, this technique did not distinguish herein between an invasive adenocarcinoma and carcinoma in situ. A cellular doubling time of 56 h was calculated from one tumor. When unsuspected invasive gallbladder cancer is found after LC, lapar oscopic port sites should be inspected at reoperation and, at a minimu m, the port site through which the gallbladder was removed should be w idely excised. This demonstration of cancer recurrence in laparoscopic port sites may limit the application of laparoscopy to elective cance r resection.