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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References
- Parietal seeding of carcinoma of the gallbladder after laparoscopic cholecystectomy.Br J Surg. 1992; 79: 230
- Laparoscopic colorectal surgery-are we being honest with our patients?.Dis Colon Rectum. 1995; 38: 723-727
- The effect of laparoscopy on the movement of tumor cells and metastasis to surgical wounds.Surg Endosc. 1997; 11: 1163-1166
- Cells are present in the smoke created during laparoscopic surgery.Br J Surg. 1997; 84: 993-995
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© 2002 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
