Laparoskopik Kolesistektomi Yapılan Hastalarda Rastlantısal Safra Kesesi Kanseri Sıklığı

Year 2023, Volume: 20 Issue: 3, 593 - 598, 31.12.2023

Serkan Erkan , Hakan Yabanoğlu

https://doi.org/10.35440/hutfd.1328672

Abstract

Amaç: Safra kesesi kanserleri nadir görülen ve tanısı patolojik inceleme ile konulabilen hastalıklardır. Bu çalışmada laparoskopik kolesistektomi yapılan hastalarda rastlantısal safra kesesi kanseri sıklığımızı saptayarak "safra kesesi kanseri insidansını azaltmak için safra kesesi hastalıklarında kolesistektomi endikasyonlarını genişletmeli miyiz?" sorusuna cevap bulmayı amaçladık.
Materyal ve metod: Ocak 2011- Ocak 2023 tarihleri arasında kolesistektomi yapılan hastaların dosyala-rını geriye dönük olarak incelendi. 18 yaş altı , açık kolesistektomi yapılan, ameliyat öncesi tanı alan ve eş zamanlı farklı onkolojik hastalık taşıyan hastalar çalışma dışında bırakıldı. Safra kesesi hastalığı nedeniyle laparoskopik kolesistektomi yapılan 18 yaş üstü hastalar çalışmaya dahil edildi. Rastlantısal olarak safra kesesi kanseri saptanan hastaların demografik verileri, radyolojik incelemeleri, patoloji raporları, evreleri, takip ve tedavi sonuçları kaydedildi.
Bulgular: Belirlenen tarih aralığında kolesistektomi yapılan 4499 hastanın 3324’ü çalışmaya dahil edilme kriterlerini karşılıyordu. Dokuz (%0.27) hastada rastlantısal olarak safra kesesi kanseri tespit edildi. Hastaların 5(%55.5)’i erkekti (E/K:5/4) ve yaş ortalamaları 67.3 (47-78) yıldı. Beş hastaya sadece laparoskopik kolesistektomi yapılırken dört hastaya kolesistektomi sonrasında geniş rezeksiyon sonrası adjuvan kemoterapi verildi. Mortalite oranı %55.5 (n=5)’di.
Sonuç: Safra kesesi kanserlerinde erken evrede yakalanan hastalarda neticeler yüz güldürücüdür. Rastlantısal kanser olasılığı nedeniyle radyolojik inceleme ve histopatolojik değerlendirme itina ile yapılmalıdır. Erken yaşta tanı alan benign hastalıklarda semptomatik olmasa dahi yapılacak erken cerrahi tercihi kanser insidansını azaltabilir.

Keywords

Safra taşı, Kolesistektomi, Safra kesesi kanseri

Supporting Institution

Başkent Üniversitesi

Project Number

KA21-389

The Frequency of Incidental Gallbladder Cancer in Patients Undergoing Laparoscopic Cholecystectomy

Abstract

Background: Gallbladder cancers are rare diseases that can be diagnosed by pathological examination. In this study, we determined the frequency of incidental gallbladder cancer in patients who under-went laparoscopic cholecystectomy and asked, "Should we expand the indications for cholecystecto-my in in gallbladder diseases to reduce the incidence of gallbladder cancer?" We aimed to find an answer to the question.
Materials and Methods: The files of patients who underwent cholecystectomy between January 2011 and January 2023 were reviewed retrospectively. Patients under the age of 18 who underwent open cholecystectomy, were diagnosed preoperatively and had different concomitant oncological diseases were excluded from the study. Patients over the age of 18 who underwent laparoscopic cholecystec-tomy for benign gallbladder disease were included in the study. Demographic data, radiological examinations, pathology reports, stages, follow-up and treatment, and results of patients with inci-dentally diagnosed gallbladder cancer were recorded.
Results: Of the 4499 patients who underwent cholecystectomy within the specified date range, 3324 met the inclusion criteria. Gallbladder cancer was detected incidentally in nine (0.27%) patients. 5 (55.5%) of the patients were male (M/F:5/4) and their mean age was 67.3 (47-78) years. While five patients underwent only laparoscopic cholecystectomy, four patients received adjuvant chemothe-rapy after extensive resection after cholecystectomy. The mortality rate was 55.5% (n=5).
Conclusions: The results are satisfactory in patients with gallbladder cancers diagnosed at an early stage. Because of the possibility of coincidental cancer, radiological examination and histopathologi-cal evaluation should be done with care. Even if it is not symptomatic, the choice of early surgery in benign diseases diagnosed at an early age should be reviewed with new studies.

Keywords

Gallstone, Cholecystectomy, Gallbladder cancer

Ethical Statement

Başkent Üniversitesi Tıp ve Sağlık Bilimleri Etik Kurulu tarafından onaylanmış (tarih: 03/ 08/ 2022; no: KA/21389) ve Helsinki Deklarasyonuna uygun olarak dizayn edilmiştir.

Project Number

KA21-389

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