Use of Retrieval Bags in Incidental Gallbladder Cancer Cases

Goetze, Thorsten; Paolucci, Vittorio
October 2009
World Journal of Surgery;Oct2009, Vol. 33 Issue 10, p2161
Academic Journal
Accidental intraoperative gallbladder perforation is a problem in laparoscopic surgery, especially in cases with incidental gallbladder carcinoma (IGBC). The question is whether intraoperative gallbladder perforation has a prognostic disadvantage or a retrieval bag provides protection against tumor dissemination. A standardized questionnaire was sent to all German surgical clinics based on the central register of “incidental gallbladder carcinoma” of the German Society of Surgery founded in 1997. In 592 IGBC-registered cases, there were 330 laparoscopies, 154 open surgeries, and intraoperative conversion was performed in 106 cases. Of laparoscopic surgeries ( n = 330), the recurrence rate was 30%. The recurrence rate for cases with (174/330) and without (156/330) the use of retrieval bag was 32.2% and 27%, respectively. In laparoscopies with intraoperative gallbladder perforation (73/330 cases), the recurrence rate was 38.4%. Of these cases the recurrence rate with (51/73) and without (22/73) the use of retrieval bags was 39.2% and 36.4%, respectively. In 257 cases without intraoperative perforation, tumor recurrence rate was 27.2%, and it was 29.3% or 25.4% with (123/257) and without (134/257) the use of retrieval bags. According to the registry data, the intraoperative gallbladder perforation results in significant ( P = 0.047) prognostic disadvantage and in these cases retrieval bags were used more often ( P = 0.001). However, in IGBC cases if intraoperative gallbladder perforation has already happened, the use of retrieval bags had no protective effects.


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