Abstracts Poster Abstracts - Dr Falk

60Port-site metastasis after laparoscopic cholecystectomy forbenign gallbladder disease with an occult cholangiocellularcarcinoma. A case reportIrfan Koruk (1), Senem Koruk (2), Sedat Ozdede (3)Gaziantep State Hospital Department of Gastroenterology (1) and Surgery (3),Gaziantep University School of Medicine Department of Anesthesiology andReanimation (2), Gaziantep, TurkeyIntroduction: Port-site metastasis after laparoscopy, well-known entity, after benigndiseases is such a rare condition. We report a case of port-site metastasis after laparoscopiccholecystectomy for benign gallbladder disease with an occult cholangiocellularcarcinoma.Case Report: LS, is a 73-years-old, male patient. Laparoscopic cholecystectomy wasperformed in December 2002 for chronic cholecystitis due to cholelithiasis. Thepathological examination of the surgical specimen was benign. 18 months later from thesurgery there had been a granulation on the trocar site at the umbilicus. It was excisedand was reported as well differentiated adenocarcinoma. On October 2004, there hadbeen another nodular lesion on the abdominal wall, which was reported, malignant also.On December 2004 the patient has presented to us with jaundice, abdominal pain andhigh body temperature. The liver enzymes were elevated. The markers for acutehepatitis were negative. Intrahepatic billiary tract dilatation was seen at abdominal US.ERCP was done. The main choleduct was measured 9 mm, and 1.5 cm distally from thehilus there was a stricture for 2 cm distances. Intrahepatic billiary tract was dilated. Afterendoscopic sphincterotomy, a plastic biliary stent was implanted. The diagnosis afterERCP was cholangiocellular carcinoma. For six months from the diagnosis, stentingwas done for three times due to cholangitic attacks. At the thoracic CT scan there wasa metastatic lesion on April 2005.Discussion/Conclusion: Port-site metastasis is a well-known entity after laparoscopyfor malignant diseases. There were three cases of metastasis after benign diseases. Inour case it was thought that there was an occult cholangiocellular carcinoma while thefirst operation done. Before the symptoms of cholangiocellular carcinoma, the port-sitemetastases were seen. In our opinion all pathologies on the port-site should beinvestigated. It may be the first sign of an intraabdominal occult malignancy.