[Fortuitous discovery of XXXX ].

@entity1 @entity5 @entity13712 @entity150 @entity3 @entity1086 @entity516
The prognosis of @entity1086 is basically dependent on the histological stage at diagnosis. In practice, the discovery of a small @entity150 , generally during cholecystectomy give the @entity1 a better care for curative treatment. The advent of laparoscopy has increased the number of cholecstectomies and could increase the frequency of this situation but also raises the difficult problem of metastatic dissemination. In the literature the figures on parietal @entity3 after laparoscopy have ranged from 125% to 19%. The median delay to diagnosis of recurrence is 6 months. The cause of this phenomenon (role of the @entity516 ) remains poorly elucidated. Risk factors for the development of a @entity3 on the trocar orifice are: rupture of the gallbladder perioperatively and extraction of the gallbladder without protection. It is important to keep in mind this exceptional but serious risk and apply rigorous operative technique. In case of suspected gallbladder we do not advocate laparoscopy. Surgery (hepatectomy, lymphodenectomy, possibly resection of the biliary tract) would be indicted for all stages except pTis and @entity13712 , taking into consideration the localization of the @entity5 and the @entity1 's general status. It is also classical to recommend resection of the trocar orifices after laparoscopic cholecystectomy. There is a dual challenge today for small-sized @entity1086 : improving treatment and avoiding poorer prognosis due to the specific problems raised by laparoscopy.
