Laparoscopic cholecystectomy and unsuspected gallbladder cancer

Gallbladder cancer is a relatively uncommon malignancy. Its presentation is similar to that of gallstone disease and sometimes with non-specific sympt oms. Laparoscopic cholecystectomy has become the method of choice for remov ing the gallbladder in most benign conditions. Occasionally, unsuspected ga llbladder carcinoma is encountered in association with laparoscopic cholecy stectomy. Overall gallbladder cancers have a poor prognosis, despite surger y or adjuvant therapies. However, in selected cases, a favourable outcome c an be expected and the less favourable predicted outcome can be improved. M anagement of patients with gallbladder cancer in different situations is di scussed: gallbladder cancer noted post-operatively on final pathology, gall bladder cancer noted after removal of the gallbladder and opening of the sp ecimen at the time of surgery, difficulty encountered at the time of dissec tion and resultant suspicion of gallbladder cancer, and diagnosis of extens ive disease at initial placement of the laparoscope. (C) 2001 Harcourt Publ ishers Ltd.