A Different Perspective on Macroscopic Sampling of Cholecystectomy Specimens

Abstract

BackgroundBecause there may be interdepartmental differences in macroscopic sampling of cholecystectomy specimens, we aimed to investigate differences between the longitudinal sampling technique and our classical sampling technique in cholecystectomy specimens in which there was no obvious malignancy.MethodsSix hundred eight cholecystectomy specimens that were collected between 2011 and 2012 were included in this study. The first group included 273 specimens for which one sample was taken from each of the fundus, body, and neck regions (our classical technique). The second group included 335 specimens for which samples taken from the neck region and lengthwise from the fundus toward the neck were placed together in one cassette (longitudinal sampling). The Pearson chi-square, Fisher exact, and ANOVA tests were used and differences were considered significant at p<.05.ResultsIn the statistical analysis, although gallbladders in the first group were bigger, the average length of the samples taken in the second group was greater. Inflammatory cells, pyloric metaplasia, intestinal metaplasia, low grade dysplasia, and invasive carcinoma were seen more often in the second group.ConclusionsIn our study, the use of a longitudinal sampling technique enabled us to examine a longer mucosa and to detect more mucosal lesions than did our classical technique. Thus, longitudinal sampling can be an effective technique in detecting preinvasive lesions.

The contribution of additional sampling in cholecystectomy materials: a multicenter prospective study

“…In the case of adenocarcinoma found in a cholecystectomy material, the treatment plan also changes. Extension of the surgical resection area, lymphadenectomy, There are several studies conducted on the frequency of epithelial anomalies and sampling methods in our country (4,30). Argon et al (4) recommend that a longitudinal sample starting from the neck of the gallbladder to the fundus should be obtained and placed into the cassette as a rolled-up (Swiss roll) figure.…”

“…A Multicenter Prospective Study (4)(5)(6)(7)(8) and all these methods are important in detecting incidental gallbladder cancer. The Hepato-Pancreato-Biliary (HPB) Pathology Study Group has also conducted a multicenter retrospective study to assess gallbladder lesions and establish common macroscopy and microscopy protocols in our country (9).…”

Incidental Gallbladder Carcinoma and Precancerous Lesions In Laparoscopic Cholecystectomy Specimens

“…Our rate is a bit lower than that of literature and it may be associated with inadequate sampling of cholecystectomy specimens. Argon et al (11) studied on macroscopic sampling of cholecystectomy specimens. Their first group included 273 specimens for which one sample was taken from each of the fundus, body and neck regions (classical technique).…”

Optimal block sampling of routine, non‐tumorous gallbladders

“…A literature search failed to reveal any specifically designed, prospective study producing data to justify the above recommendations or proposals. Argon et al . studied block sampling of gallbladders, but specifically and only compared a longitudinal sampling technique (335 gallbladders) with a three‐section sampling technique (273 gallbladders).…”

“…A literature search failed to reveal any specifically designed, prospective study producing data to justify the above recommendations or proposals. Argon et al 5 studied block sampling of gallbladders, but specifically and only compared a longitudinal sampling technique (335 gallbladders) with a three-section sampling technique (273 gallbladders). Before that, Duarte et al 6 completely blocked 162 gallbladders, but focused on dysplasia and metaplasia, and only studied a Chilean population -that is recognized to harbour a much higher incidence of gallbladder neoplasia.…”