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Clinical characteristics of incidental or unsuspected gallbladder cancers diagnosed during or after cholecystectomy: A systematic review and meta-analysis

Authors
Choi, Kui SunChoi, Sae ByeolPark, PyoungjaeKim, Wan BaeChoi, Sang Yong
Issue Date
28-1월-2015
Publisher
BAISHIDENG PUBLISHING GROUP INC
Keywords
Gallbladder cancer; Laparoscopic surgery; Cholecystectomy; Revisional surgery; Incidental diagnosis
Citation
WORLD JOURNAL OF GASTROENTEROLOGY, v.21, no.4, pp.1315 - 1323
Indexed
SCIE
SCOPUS
Journal Title
WORLD JOURNAL OF GASTROENTEROLOGY
Volume
21
Number
4
Start Page
1315
End Page
1323
URI
https://scholar.korea.ac.kr/handle/2021.sw.korea/94608
DOI
10.3748/wjg.v21.i4.1315
ISSN
1007-9327
Abstract
AIM: To perform a systematic review of incidental or unsuspected gallbladder (GB) cancer diagnosed during or after cholecystectomy. METHODS: Data in PubMed, EMBASE, and Cochrane Library were reviewed and 26 publications were included in the meta-analysis. The inclusion criterion for incidental GB cancer was GB cancer diagnosed during or after cholecystectomy that was not suspected at a preoperative stage. Pooled proportions of the incidence, distribution of T stage, and revisional surgery of incidental GB cancer were analyzed. RESULTS: The final pooled population comprised 2145 patients with incidental GB cancers. Incidental GB cancers were found in 0.7% of cholecystectomies performed for benign gallbladder diseases on preoperative diagnosis (95%CI: 0.004-0.012). Nearly 50% of the incidental GB cancers were stage T2 with a pooled proportion of 47.0% (95%CI: 0.421-0.519). T1 and T3 GB cancers were found at a similar frequency, with pooled proportions of 23.0% (95%CI: 0.178-0.291) and 25.1% (95%CI: 0.195-0.317), respectively. The pooled proportion that completed revisional surgery for curative intent was 40.9% (95%CI: 0.329-0.494). The proportion of patients with unresectable disease upon revisional surgery was 23.0% (95%CI: 0.177-0.294). CONCLUSION: A large proportion of incidental GB cancers were T2 and T3 lesions. Revisional surgery for radical cholecystectomy is warranted in T2 and more advanced cancers.
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