EARLY INTRAPERITONEAL DISSEMINATION AFTER RADICAL RESECTION OF UNSUSPECTED GALLBLADDER CARCINOMA FOLLOWING LAPAROSCOPIC CHOLECYSTECTOMY

We describe a case of early intraperitoneal dissemination after a radi cal second operation following laparoscopic cholecystectomy for unsusp ected locally advanced carcinoma of the gallbladder. A radical procedu re including wedge resection of the gallbladder bed, resection of the extrahepatic bile ducts, and dissection of the regional nodes and inte raortocaval nodes was performed 17 days after laparoscopic cholecystec tomy in a 60-year-old woman. The final histologic examination revealed a moderately differentiated adenocarcinoma invading perimuscular conn ective tissue with one positive pericholedochal node (pT2, pN1, pM0). Despite the absence of intraperitoneal dissemination at reexploration, the patient had intraperitoneal dissemination 5 months after the seco nd operation. Insidious intraperitoneal dissemination may decrease the survival rate of locally advanced carcinoma of the gallbladder after laparoscopic cholecystectomy compared with open cholecystectomy. Surge ons should search for unsuspected carcinoma of the gallbladder intraop eratively to avoid implantation metastasis.