Analysis of Incidental Gallbladder Cancer in Cholecystectomies

Abstract

Objective: To study incidental gallbladder cancer (IGBC) incidence in patients who underwent cholecystectomy. Methods: The records of patients who underwent cholecystectomy between 2004-2019 were retrospectively reviewed. The demographic information, preoperative radiological findings of the patients diagnosed with gallbladder cancer (GBC), as a result of routine histopathological examination and operation records, were reviewed and findings were recorded. The preoperative radiological records of the patients with GBC and, if any, findings of GBC suspected during surgery were recorded. Results: Between 2004-2019, a total of 6314 patients underwent cholecystectomy. Of the patients, 5404 (85.59%) were female and 910 (14.41%) were male. The median age was 47 years (min:19, max:94) and the mean age was 47.28±14.60 years. Nine out of 6314 patients (0.14%) were diagnosed with GBC by postoperative histopathological examination. All patients with GBC were female and their mean age was 64.33±11.08 years. Two out of nine GBC cases were prediagnosed with GBC in preoperative radiological findings; the remaining seven (0.11%) had IGBC without any preoperative findings. Conclusion: Asian populations are reported to have a higher incidence of GBC. Turkey is located in the transition zone between Asia and Europe. However, the GBC rates in our study remain far below the rates reported in Asian publications. We believe that our results may be affected by the predominantly Mediterranean-type diet and the relatively higher socioeconomic level of the region where we conducted our study. Consequently, we recommend routine histopathological examination after cholecystectomies in regions with a high incidence of GBC.

Cáncer de vesícula biliar como hallazgo histopatológico posterior a colecistectomía. Prevalencia e incidencia a trece años en el Hospital Angeles Pedregal

“…El número de personas sometidas a colecistectomía durante el periodo mencionado es similar al descrito en otros estudios internacionales en un periodo similar (2004-2019) con 6,314 casos. 3 En una publicación mexicana longitudinal, retrospectiva, observacional a cinco años (2009-2013) en donde se obtuvo un total de 903 colecistectomías, se encontró una prevalencia de 0.4%, siendo la colecistitis crónica y aguda los factores asociados más frecuentes. 11 Es importante mencionar los resultados obtenidos durante un periodo de seis años en la misma población, en donde se reportó una prevalencia de 0.26, lo cual podría ser un indicador de mantenimiento de una población estable.…”

“…1 Los factores de riesgo reportados son edad mayor a 65 años, sexo femenino, la inflamación crónica, colelitiasis, pólipos (> 1 cm), anomalías en la unión pancreatobiliar, entre otros menos comunes. 3,4 Asimismo, se consideran factores predisponentes el síndrome de Mirizzi, enfermedad por reflujo gastroesofágico y calcificación de la pared vesicular. 5 Los pólipos de la vesícula biliar se observan en hasta 12% de las muestras de colecistectomía y entre 5 y 7% de los estudios de ecografía biliar, pero sólo 0.6% de los pólipos son malignos.…”

“…Las tasas de cáncer vesicular incidental (diagnosticado durante el acto quirúrgico o por reporte de patología postoperatorio) varía entre regiones, reportándose en diferentes series tasas de entre 0.2 y 3.3%. 3 Aproximadamente uno de cada 250 colecistectomías laparoscópicas producirá un diagnóstico patológico de CVB incidental. 6 La variedad histológica más común del cáncer de vesícula es el adenocarcinoma, aunque se han reportado tumores neuroendocrinos, tumores de células pequeñas, linfoma primario no Hodgkin, así como metástasis.…”

Essential updates 2019/2020: Surgical treatment of gallbladder cancer

“…In 2019‐2020, seven case‐controlled studies (Table 1) and nine case‐series studies were published on IGBC. In these studies, the frequency of IGBC was reported to be between 0.11% and 2.5%, 28–35 and Fujiwara et al reported that the incidence of IGBC in cholelithiasis was 0.054%, whereas in acute cholecystitis, the incidence was as high as 1.3%, with more advanced cases 36 . Figueiredo et al also reported that 49 (0.77%) of 6329 cholecystectomy cases had IGBC, and while 23 (0.38%) of 5931 were elective surgery cases, a higher rate of 26 (6.53%) of 398 were emergency surgery cases 28 .…”

Câncer Incidental de Vesícula Biliar: Recorte Estatístico em um Hospital Terciário em Fortaleza, CE, Brasil

“…Na literatura, encontrou-se uma prevalência desse achado em aproximadamente 0,2-3% das colecistectomias realizadas. No Brasil, existem poucos estudos sobre esse indicador, e os que existem são apenas estudos regionais 1,4 .…”