Background : Gallbladder carcinoma (GBC) is incidentally found after laparoscopic cholecystectomy (LC) and Extended resection with reginal lymph node dissection is recommended in most patients. Recently many centers have reported that a laparoscopic approach for postoperatively diagnosed GBC could be feasible, with satisfactory clinical outcomes including oncologic results. However, laparoscopic approach seems to be technically challenging for incidental GBC after LC with acute cholecystitis because of inflammatory adhesions or fibrosis. Herein, we present laparoscopic liver resection with regional lymphadenectomy in patients with an incidental GBC after LC with acute cholecystitis.

Methods : From June 2018 to Dec 2022, 10 patients received laparoscopic reoperation for postoperatively diagnosed GBC.

Results : One patient had T1b GBC and others had T2 GBC. One patient received concomitant bile duct resection due to cystic duct invasion. Median operative time was 249(183-340) min and Estimate blood loss was 175(130-300) ml. Postoperative stay was 10 days (7-13) There is no major complications after operation and most postoperative outcomes were comparable to those of immediate conversion group with laparoscopic approach. No tumor recurrence occured in all patients during follow up periods.

Conclusions : Laparoscopic approach could be a feasible option for incidental early GBC (T1b and T2) after LC with acute cholecystitis without significantly adverse postoperative outcomes in spite of technical complexity.