Clinicalcharacteristicsofincidentalorunsuspectedgallbladdercancersdiagnosedduringoraftercholecystectomy:Asystematicreviewandmeta-analysis

摘要： AIM:Toperformasystematicreviewofincidentalorunsuspectedgallbladder(GB)cancerdiagnosedduringoraftercholecystectomy.METHODS:DatainPubMed,EMBASE,andCochraneLibrarywerereviewedand26publicationswereincludedinthemeta-analysis.TheinclusioncriterionforincidentalGBcancerwasGBcancerdiagnosedduringoraftercholecystectomythatwasnotsuspectedatapreoperativestage.Pooledproportionsoftheincidence,distributionofTstage,andrevisionalsurgeryofincidentalGBcancerwereanalyzed.RESULTS:Thefinalpooledpopulationcomprised2145patientswithincidentalGBcancers.IncidentalGBcancerswerefoundin0.7%ofcholecystectomiesperformedforbenigngallbladderdiseasesonpreoperativediagnosis(95%CI:0.004-0.012).Nearly50%oftheincidentalGBcancerswerestageT2withapooledproportionof47.0%(95%CI:0.421-0.519).T1andT3GBcancerswerefoundatasimilarfrequency,withpooledproportionsof23.0%(95%CI:0.178-0.291)and25.1%(95%CI:0.195-0.317),respectively.Thepooledproportionthatcompletedrevisionalsurgeryforcurativeintentwas40.9%(95%CI:0.329-0.494).Theproportionofpatientswithunresectablediseaseuponrevisionalsurgerywas23.0%(95%CI:0.177-0.294).CONCLUSION:AlargeproportionofincidentalGBcancerswereT2andT3lesions.RevisionalsurgeryforradicalcholecystectomyiswarrantedinT2andmoreadvancedcancers. ... （共9页）