A selective approach to histopathology of the gallbladder is justifiable

Dix, F.P.; Bruce, Iain; Krypcyzk, A.; Ravi, Srinivasan

doi:10.1016/s1479-666x(03)80023-9

Cited by 48 publications

(48 citation statements)

References 5 publications

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“…On histopathological examination also, as we have seen, there may be only subtle changes which may be missed by inexperienced and casual observer. Some authors have suggested selective histopathological examination of the cholecystectomy specimens in order to reduce cost, taking account of some parameters like clinical presentation, intraoperative finding etc, but no detailed study has been conducted regarding these parameters so far (Dix et al, 2003;Darmas et al, 2007;Chin et al, 2010;De Zoysa et al, 2010). In our experience, these parameters are not sufficient to differentiate malignant from benign ones.…”

Section: Discussionmentioning

confidence: 83%

Impact of Routine Histopathological Examination of Gall Bladder Specimens on Early Detection of Malignancy - A Study of 4,115 Cholecystectomy Specimens

Kalita

Pant²,

Singh³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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Section: Discussionmentioning

confidence: 83%

Impact of Routine Histopathological Examination of Gall Bladder Specimens on Early Detection of Malignancy - A Study of 4,115 Cholecystectomy Specimens

Kalita

Pant²,

Singh³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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“…These series confirm that there was not a single case of invasive adenocarcinoma of the gall bladder that would have been missed if only macroscopically abnormal specimens were examined. [7][8][9] In recent years, we have witnessed a significant increase in a consultant histopathologist's workload. In response to the mounting pressure on pathological services, the Royal College of Pathologists published guidelines on workload and safe staffing levels in pathology departments.…”

Section: Discussionmentioning

confidence: 99%

Is there Any Justification for the Routine Histological Examination of Straightforward Cholecystectomy Specimens?

Darmas

Mahmud

Abbas

et al. 2007

annals

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Ann R Coll Surg Engl 2007; 89: 238-241 238Adenocarcinoma of the gall bladder is a rare but aggressive gastrointestinal malignancy. It carries a dismal prognosis, with a reported overall 5-year survival rate not exceeding 5%.1 According to a large multicentre survey commissioned by the French Surgical Association, the overall median survival is just 3 months, 2 the main reason being late presentation. It mainly affects patients in their 7th and 8th decade and is about 5 times more common in females. It is estimated that in 85% of cases it is associated with gallstones 3 but the only recognised pre-malignant condition is a 'porcelain gall bladder'. In the vast majority of patients who are diagnosed with gall bladder carcinoma, the first suspicion of malignancy arises during operation and is confirmed on histological examination of the specimen. Despite advances in radiological imaging, accurate preoperative diagnosis is the exception rather than the rule. At present, all specimens, regardless of their macroscopic appearance, are being sent for histological examination. It seems questionable whether the result of the histopathological examination of each gall bladder would alter management when it provides no advantage to the surgeon, patient or pathologist.The aim of the study was to assess the necessity of routine histological examination of the gall bladder following simple cholecystectomy and its impact on the further management of the patients. Patients and MethodsWe analysed, retrospectively, the electronic database of histological reports of all gall bladder specimens after cholecystectomy in the last 5 years. In all cases of confirmed malignancy, we retrieved and reviewed, from patients notes and, when missing, from the hospital electronic database, results of pre-operative investigations such as: liver function tests, ultrasound scans or computed tomography Gall bladder carcinoma is a rare malignancy that carries a very poor prognosis. Laparoscopic cholecystectomy (LC) is established as the gold-standard treatment for symptomatic gall stones. The aim of the study was to assess the incidence of gall bladder carcinoma and the possibility of reducing the routine histological examination of gall bladder specimens.

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“…4 Saving the time and resources of pathology departments also contributes to deciding the necessity of routine evaluation. 1,3,6,7 'Unexpected primary gallbladder cancer' (UPGC) is defined as cancer that is diagnosed using histology only after removal of the gallbladder with a presumed diagnosis of benign disease. UPGC has been reported in 0.3-2% of all cholecystectomy cases.…”

mentioning

confidence: 99%

“…5 In 2003, Dix and colleagues approved the same approach, and stated that routine histopathological evaluation of gallbladder specimens provides no favourable service to the patient, surgeon, or pathologist. 6 In 2007,…”

mentioning

confidence: 99%

Incidental findings during routine pathological evaluation of gallbladder specimens: review of 1,747 elective laparoscopic cholecystectomy cases

Başak

Hasbahçeci

Canbak

et al. 2016

annals

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INTRODUCTION Cholecystectomy for benign gallbladder diseases can lead to previously undiagnosed gallbladder cancer during histopathological evaluation. Despite some controversy over its usefulness, histopathological evaluation of all gallbladder specimens is common in most hospitals. We evaluated the results of routine pathology of the gallbladder after cholecystectomy for benign gallbladder diseases with regard to unexpected primary gallbladder cancer (UPGC). METHODS Patients undergoing cholecystectomy because of benign gallbladder diseases between 2009 and 2013 were enrolled in this study. All gallbladder specimens were sent to the pathology department, and histopathological reports were examined in detail. The impact of demographic features on pathological diagnoses and prevalence of UPGC assessed. Data on additional interventions and postoperative survival for patients with UPGC were collected. RESULTS We enrolled 1,747 patients (mean age, 48.7±13.6 years). Chronic cholecystitis was the most common diagnosis (96.3%) and was associated significantly with being female (p=0.001). Four patients had UPGC (0.23%); one was stage T3 at the time of surgery, and the remaining three cases were stage T2. CONCLUSIONS Routine histopathological examination of the gallbladder is valuable for identification of cancer that requires further postoperative management.

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A selective approach to histopathology of the gallbladder is justifiable

Cited by 48 publications

References 5 publications

Impact of Routine Histopathological Examination of Gall Bladder Specimens on Early Detection of Malignancy - A Study of 4,115 Cholecystectomy Specimens

Impact of Routine Histopathological Examination of Gall Bladder Specimens on Early Detection of Malignancy - A Study of 4,115 Cholecystectomy Specimens

Is there Any Justification for the Routine Histological Examination of Straightforward Cholecystectomy Specimens?

Incidental findings during routine pathological evaluation of gallbladder specimens: review of 1,747 elective laparoscopic cholecystectomy cases

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