Letter| Volume 131, ISSUE 3, P362, March 2002

Letter to the editors

      A 79-year-old woman underwent a laparoscopic cholecystectomy for cholelithiasis. The laparoscope was introduced through a 10-mm trocar placed in a periumbilical incision, while the pneumoperitoneum was maintained with carbon dioxide gas. The procedure was converted to open surgery because of significant adhesions between the gallbladder, duodenum, and peritoneum. We did not use any port other than the umbilical port, and did not touch the gallbladder or other organs during the laparoscopic procedure. Open cholecystectomy and partial duodenectomy were performed through the mid-upper abdominal wound. Histopathological findings showed a moderately differentiated tubular adenocarcinoma. Ten months later, the patient re-presented with a nodule at the periumbilical port site, which proved to be metastatic gallbladder carcinoma localized in the subcutaneous tissue and muscle layer at the periumbilical port site. No recurrence was detected in the open laparotomy wound.
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