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Recurrent Gallbladder Carcinoma along Laparoscopic Cholecystectomy Port Tracks: CT Demonstration¹

¹ From the Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10021. Received July 31, 1998; revision requested September 10; revision received October 28; accepted January 11, 1999. Address reprint requests to C.B.W. (e-mail: winstonc@mskcc.org).

PURPOSE: To describe the computed tomographic (CT) appearance of recurrent gallbladder carcinoma along port tracks after laparoscopic cholecystectomy and to assess the effect of recurrence on patient care.

MATERIALS AND METHODS: Seventeen abdominal CT scans in 16 of 19 consecutive patients who underwent hepatic resection for gallbladder carcinoma diagnosed at laparoscopic cholecystectomy were reviewed retrospectively. Medical records were reviewed to determine the clinical effect of tumor recurrence along a port track.

RESULTS: CT revealed 12 tumor recurrences along laparoscopic port tracks in six (32%) patients (mean, two recurrences per patient; range, one to four per patient). Eight (67%) CT-depicted recurrences appeared homogeneous, and nine (75%) directly involved subjacent omental fat. The mass was the only site of recurrence at CT in two (33%) patients. The presence of an abdominal wall tumor recurrence affected patient care in four (67%) of six patients. Histopathologic examination results confirmed recurrent tumor in all five (100%) patients who underwent biopsy.

CONCLUSION: Tumor recurrence along port tracks is a potential complication of laparoscopic cholecystectomy when gallbladder carcinoma is present, even after subsequent hepatic resection is performed for attempted cure. Recurrences appear as a new or enlarging abdominal wall mass, often involving subjacent omental fat, and may be the only site of recurrent disease at CT. Demonstration of abdominal wall tumor recurrence affects patient care.

Index terms: Abdominal wall, 762.331 • Cholecystectomy, 762.1267 • Gallbladder, CT, 762.12112, 762.12115 • Gallbladder, MR, 762.121411 • Gallbladder, neoplasms, 762.32 • Laparoscopic surgery, 762.1267 • Surgery, complications, 762.458

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