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When surgeons went back in after a gallbladder cancer had been found by chance, nearly half of patients had cancer left behind, and the deeper the original tumour the more likely it was.
Six hepatobiliary centres pooled 115 patients re-resected between 1984 and 2006 for gallbladder carcinoma discovered incidentally at cholecystectomy. T stage was T1 in 7.8 percent, T2 in 67.0 percent and T3 in 25.2 percent; the median interval to re-resection was 52 days. Residual or additional disease was found in 46.4 percent. Residual disease in the liver was found in 0, 10.4 and 36.4 percent of T1, T2 and T3 tumours and nodal metastasis in 12.5, 31.3 and 45.5 percent. A positive cystic duct margin predicted residual disease in the common bile duct (42.1 versus 4.3 percent). Common duct resection did not raise the lymph node count (median 3 in both groups).
This is the observational backbone of the rule that T1b or deeper incidental cancers should be re-resected, and of resecting the bile duct only when the cystic duct margin is positive.
Shares Test whether T1b gallbladder cancer needs the second operation at all, Incidental gallbladder cancer (found after cholecystectomy), Radical (extended) cholecystectomy, Gallbladder cancer roadmap: from a chance finding at gallstone surgery to a disease with its own trials and the tag gallbladder-evidence.
Shares Incidental gallbladder cancer (found after cholecystectomy), Radical (extended) cholecystectomy, Gallbladder cancer roadmap: from a chance finding at gallstone surgery to a disease with its own trials, Gallbladder cancer and the tag gallbladder-evidence.
Shares Incidental gallbladder cancer (found after cholecystectomy), Radical (extended) cholecystectomy, Gallbladder cancer roadmap: from a chance finding at gallstone surgery to a disease with its own trials, Gallbladder cancer and the tag gallbladder-evidence.
Shares Incidental gallbladder cancer (found after cholecystectomy), Radical (extended) cholecystectomy, Gallbladder cancer roadmap: from a chance finding at gallstone surgery to a disease with its own trials, Gallbladder cancer and the tag gallbladder-evidence.
Shares Incidental gallbladder cancer (found after cholecystectomy), Gallbladder cancer roadmap: from a chance finding at gallstone surgery to a disease with its own trials, Gallbladder cancer and the tag gallbladder-evidence.
Shares Incidental gallbladder cancer (found after cholecystectomy), Radical (extended) cholecystectomy, Gallbladder cancer roadmap: from a chance finding at gallstone surgery to a disease with its own trials, Gallbladder cancer and the tag gallbladder-evidence.
Shares Incidental gallbladder cancer (found after cholecystectomy), Radical (extended) cholecystectomy, Gallbladder cancer roadmap: from a chance finding at gallstone surgery to a disease with its own trials, Gallbladder cancer and the tag gallbladder-evidence.
Shares Radical (extended) cholecystectomy, Gallbladder cancer roadmap: from a chance finding at gallstone surgery to a disease with its own trials, Gallbladder cancer and the tag gallbladder-evidence.