Incidence and Preoperative Predictor Factors of Gallbladder Cancer Before Laparoscopic Cholecystectomy: a Systematic Rev
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REVIEW ARTICLE
Incidence and Preoperative Predictor Factors of Gallbladder Cancer Before Laparoscopic Cholecystectomy: a Systematic Review Tarek Kellil 1 & Mohamed Ali Chaouch 1 Faouzi Noomen 1 & Khadija Zouari 1
&
Emna Aloui 1 & Mohamed Amine Tormane 1 & Sahbi Khaled Taieb 1 &
Accepted: 17 September 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Introduction Many cases of gallbladder cancer (GBC) were made incidentally after cholecystectomy for presumed benign disease. The aim of this review is to assess the preoperative predictor factors of gallbladder cancer. Methods This systematic review was conducted according to PRISMA guidelines when it was applicable. We conducted bibliographic researches on October 2nd, 2019, in the following sources: The National Library of Medicine through PubMed, Cochrane database, and Google scholar. We have assessed the univariate and multivariate analysis outcomes. Results We included ten studies. Incidence of incidental GBC was 0.36%. Seven studies reported age as a significant predictive factor of iGBC. Comorbidities were the second significant predictor. One study found that iGBC group was more likely to have elevated TB, DB, PAL, and ALT. Another study reported a significantly higher rate of TB, PAL, and AST. One study concluded that elevated CA19-9 combined with CEA or CA-125 was significantly more frequent in the group with iGBC. Polyps, porcelain GB, GB wall thickness, and CBD dilation were reported to be associated with iGBC. iGBC group were more likely to have solitary and larger GS and gallbladder wall thickening, essentially focal. Conclusion Incidence of iGBC was 0.365% varying between 0.19 and 1.6% of laparoscopic cholecystectomy and about 50% of GBC cases. This highlights the deficiency of preoperative diagnostic features. Despite the efforts made, the rate of this condition is still high, underlining the need of new radiological technologies. Keywords Incidental . Gallbladder carcinoma . Laparoscopic cholecystectomy . Incidence
Introduction Gallbladder cancer (GBC) is rare, but extremely lethal neoplasm of the biliary tract [1]. It leads to 1.7% of all cancer deaths [2]. This tumor is generally asymptomatic for a long term. Due to the increasing frequency of laparoscopic cholecystectomy and the non-specificity of symptoms of gallbladder cancer, many cases were made incidentally after cholecystectomy for presumed benign disease [2, 3]. About half of cases were incidentally found in the pathological examination of the operative specimens. This raises the problem of requiring a second intervention to ensure an adequate oncological surgery and an optimal tumor staging. Preoperative diagnosis
* Mohamed Ali Chaouch [email protected] 1
Department of Visceral Surgery, Fattouma Bourguiba Hospital, Monastir, Tunisia
contributes to referring patients to specialized centers and performing some operative warranty measures. Surgeons must be careful to some points such as not to perforate the gallbladder, and to extract the opera
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