DIAGNOSTIC AND THERAPEUTIC CONSIDERATIONS IN ASSOCIATION OF COLORECTAL CANCER WITH BILIARY LITHIASIS
Keywords:gallstone, colorectal cancer, surgical treatment
Objectives. The association of colorectal cancer with biliary lithiasis is reported in 8-12% cases. Selecting the volume of surgery remains a question of discussion. The aim of the study was to analyse the experience of diagnosis and treatment of patients with biliary lithiasis and colon cancer.
Material and Methods. Of the 1456 patients, treated during 2011-2019 years, for biliary lithiasis, association with colon cancer was found in 8 cases, 3 – transverse colon, 1 – ascending colon, 2 – iliocecal angle, 2 – left colon.
Results. In 2 cases of partial occlusion, biliary colic concealed the sign of the right colon cancer. Laparoscopic cholecystectomy was firstly performed. For total acute occlusion, the patients were hospitalized repeatedly after 3 weeks (1 case) and 2 months (1 case). The pathology was resolved by: right hemicolectomy with primary anastomosis. In right colon cancer (3 cases) and left colon cancer (1 case), with signs of total obstruction, lithiasis was confirmed at ultrasonography. Cholecistectomy was performed simultaneously with hemicolectomy and primary anastomosis. In case of a tumor with destruction and peritumomoral abscess, Hartmann procedure was performed on the left colon and cholecystectomy was delayed. The postoperative period was complicated by wound infection (1 case), with no mortality.
Conclusion. It is more common, the association of biliary lithiasis with right colon cancer. The known history of lithiasis, in a partial occlusion, can cause frequent diagnostic errors. Performing simultaneous surgery depends on the staging of the colon cancer and the presence of bacterial infection complications.
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