Port-sites excision for gallbladder cancer incidentally found after laparoscopic cholecystectomy - 17/08/11
Abstract |
Port-site recurrence represents a severe complication in the case of incidental gallbladder cancer (ICG) discovered after laparoscopic cholecystectomy, and is reported to occur in 17% of cases. For this reason port-sites excision is an essential surgical step during the second operation, which includes liver resection (segments 4b and 5) and lymph node dissection (hepatic pedicle and retroduodeno-pancreatic region). In this article we describe a simple technique to obtain a radical port-site excision with the aim to standardize this surgical step and to perform it in a radical way. Port-sites excision is the accurate and complete excision of the parietal channel created by the trocar during the previous cholecystectomy. This channel is often Z-shaped. In the second operation, the presence of peritoneal adhesions helps to identify exactly the previous site of entry of the trocar in the peritoneal cavity. Trocar reinsertion through the abdominal wall along the correctly identified original path allows the excision of a perfect cylinder of abdominal wall including all of the layers from the skin to the peritoneum.
Le texte complet de cet article est disponible en PDF.Keywords : Gallbladder cancer, Port-sites excision, Laparoscopic cholecystectomy
Plan
Supported by a contribution of the Catholic University and the Italian Ministry of University and Scientific Research (D.1 Funds). |
Vol 191 - N° 1
P. 114-116 - janvier 2006 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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