Port-site metastasis following laparoscopic cholecystectomy: a review of the literature and a case report

Port-site metastasis following laparoscopic cholecystectomy with unsuspecte d gallbladder carcinoma is a serious problem. We reviewed 45 such cases rep orted in the English literature to date, and add another case which occurre d in a 72-year-old female 13 months after a laparoscopic cholecystectomy fo r gallstones, who also had an unapparent gallbladder carcinoma. Pre-operati ve diagnosis of gallbladder carcinoma is possible in less than 10% of cases , with a high index of suspicion. If detected during laparoscopy early conv ersion to open procedure is recommended. If diagnosed later, however, to co ntemplate further radical operation depending on histopathology, would be u nwise as a universal approach, because of increased associated morbidity an d mortality. The prospect of cure is also very unrealistic in this conditio n. (C) 2000 Harcourt Publishers Ltd.