Laparoscopic cholecystectomy does not demonstrably decrease survival of patients with serendipitously treated gallbladder cancer.

摘要: Abstract Background: The purpose of this study was to evaluate the possibility that laparoscopic cholecystectomy has worsened prognosis patients with resected gallbladder cancer; particularly for whose cancer accidentally resected. Study Design: We conducted a retrospective review Connecticut Tumor Registry data and extracted from individual patient records at 15 30 hospitals in reporting Registry, two separate time points, 1985–1988 (immediate prelaparoscopic era) 1992–95 (laparoscopic well established). There were 194 208 each 3-year period, respectively. Additional information hospital 82 91 patients, Twenty-five percent both sets presented "local" or Tis, T1, T2 disease. Results: Three-year survival localized disease 29% period 34% once established. But analysis indicated 36% did not actually undergo procedure. Fifty-nine had their discovered specimen postoperatively (serendipitously treated). A higher proportion cancers era (44% versus 24%). these 25%. If eras are grouped according whether cancer-bearing manipulated laparoscopically, 24 59 (41%) turned out be risk increased dissemination tumor. Survival (11-month median survival) statistically different serendipitously never laparoscopically (16-month survival); p=0.54 by log rank test. Conclusions: widespread adoption worsen cancer, treated have worse after manipulation than standard open cholecystectomy. aspects operative it do appear proximate cause poor