Delayed diagnosis of malignant tumors missed at laparoscopic cholecystectomy |
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Authors: | W Junger W G Junger J Hutter K Miller E Moritz |
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Institution: | (1) Second Surgical Department, Landeskrankenanstalten Salzburg, Müllner Hauptstrasse 48, 5020 Salzburg, Austria, AT;(2) Division of Trauma, Department of Surgery 8236, University of California San Diego Medical Center, 200 West Arbor Drive, San Diego, California 92103, USA, US |
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Abstract: | Background: The aim of this study was to compare the significance of routine examinations prior to laparoscopic cholecystectomy (LC)
with intraoperative abdominal investigation. Preoperative evaluation becomes increasingly important when laparoscopic procedures
are performed for the removal of gallstones because other intraabdominal diseases may coexist in these patients, mimicking
biliary tract disease.
Methods: Over the last 6 years, we treated 816 patients with symptomatic cholecystolithiasis using LC. Prior to surgery, routine tests
such as upper abdominal ultrasonography, chest radiography, and standard laboratory blood tests were carried out.
Results: Despite these routine tests, coexisting colonic cancers escaped detection in four out of 816 cases. This indicates a risk
of more ``missed pathologies' during the course of laparoscopic operations compared to standard laparotomy.
Conclusion: The risk of missing coexisting diseases during laparoscopic operations has to be minimized by placing additional emphasis
on careful evaluation of anamnesis. Physical examination and additional laboratory tests—such as analysis of tumor markers
and blood in the stool—combined with complete abdominal ultrasonography, gastroscopy, and/or complete colonoscopy should be
performed prior to LC.
Received: 6 October 1996/Accepted: 19 February 1997 |
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Keywords: | : Laparoscopic cholecystectomy — Colon cancer — Colonoscopy |
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