Delay of diagnosis in pancreatic cancer due to suspected symptomatic cholelithiasis

Background: A single centre study was conducted to examine the frequency of cholecystectomies, both open and laparoscopic, up to 2 years prior to the diagnosis of pancreatic cancer. In particular, it was of interest to investigate whether there is a diagnostic delay in a significant number of pancreatic cancer patients and if these patients already have symptoms or findings at the time of cholecystectomy that might have been indicative of the underlying malignant disease. Methods: It is demonstrated that 17 out of 186 pancreatic cancer patients (9%) underwent a cholecystectomy within the 2 years prior to cancer diagnosis. Results: A significant number of these patients showed a considerable weight loss at the time of the cholecystectomy. It is hypothesized that symptoms which led to cholecystectomies in these patients were most likely related to the pancreatic cancer. Owing to the resulting delay of pancreatic cancer diagnosis the resection rate with curative intent decreases to 35% from 44% in the whole series. Conclusion: Patients suffering from cholecystolithiasis and showing atypical symptoms or other notable findings such as considerable weight loss might be assessed in more detail pre- as well as postoperatively in order to minimize the diagnostic delay in pancreatic cancer and to avoid unnecessary operations.