Do we need histology for a normal-looking gallbladder?

Bazoua, George; Hamza, Numan; Lazim, Taha

doi:10.1007/s00534-007-1225-6

Cited by 71 publications

(69 citation statements)

References 21 publications

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“…In present study, lesions of gall bladder were more common in females than in males with a male to female ratio of 1:3.91 which was similar to other study carried out by Rahul et al [4], Asuquo et al [5], Tantia et al [6] and John et al [7], reported male to female ratio of 1:4.8; 1:5, 1:2.8 and 1:4 respectively. Most of the patients presented with pain upper abdomen, nausea and/or vomiting, which is consistent with findings by Laghari et al [8]. The most common histopathological finding in our study was chronic cholecystitis : 679(75.6%) specimens were reported as chronic inflammation with mucosal ulceration, denudation and wall infiltration by chronic inflammatory cells like neutrophils, macrophages, plasma cells and varying degree of fibrosis.…”

Section: Discussionsupporting

confidence: 91%

Study of Various Histopathological Lesions In Resected Gall Bladder Specimen: A Study In Consecutive 898 Cholecystectomies

Verma

Gupta²

2017

int.jour.sci.res.mana

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The histopathological spectrum of gall bladder is extremely variable depending on sex, race, age, countriesand institutes. There is a wide spectrum of pathologies affecting the gall bladder ranging from congenitalanomalies, calculi and its complications, non inflammatory, inflammatory to the neoplasticlesions.Gallstones are one of the major causes of morbidity and mortality all over the world. Cholelithiasis isvery common particularly in fatty, fertile and female of forty to fifty and affects male and children also . Gallstone may lead to several complications such as cholecystitis, hydrops, mucocele, internal biliary fistulaand carcinoma.Other histological alterations include acute cholecystitis, chronic cholecystitis and its variantssuch as lymphoplasmacytic and sclerosing cholecystitis, follicular cholecystitis, eosinophilic cholecystitisand xanthogranulomatous cholecystitis.Gall bladder carcinoma ranks 6 th in the gastrointestinal malignanttumour and due to non specific clinical presentation it is rarely diagnosed at an early stage . Most of theincidentally detected carcinoma are surgically resectable, with a good survival rate. Though simplecholecystectomy is said to be sufficient in stages T is and T 1a carcinomas, radical resection is stronglyrecommended in stages beyond that. This reflects the importance of histopathological study of allcholecystectomy specimens, irrespective of clinical impression.Cholecystectomy performed with provisionaldiagnosis of benign disease based on clinical, ultrasonological and computerized tomographic scanningmisses a significant numbers of early malignant lesions of gall bladder, as histopathological detection ofcarcinoma is a gold standard and will continue to be superior to clinical and radiological examination

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Section: Discussionsupporting

confidence: 91%

Study of Various Histopathological Lesions In Resected Gall Bladder Specimen: A Study In Consecutive 898 Cholecystectomies

Verma

Gupta²

2017

int.jour.sci.res.mana

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“…However, a thickened wall is not specific to malignant transformation as it is also seen in an acutely inflamed gallbladder or chronic cholecystitis. Many studies differ on their definition of a thickened wall with 3 mm or even no clearly defined cutoff point [5,6]. However, in our institution the correlation of thickness of gallbladder wall with gallbladder cancer is not taken into consideration.…”

Section: Discussionmentioning

confidence: 98%

“…A small number of literature data studied the benefits of histopathologic examination of these two common surgical specimens [2][3][4][5][6][7].…”

Section: Discussionmentioning

confidence: 99%

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Routine Histopathologic Examination of Two Common Surgical Specimens—Appendix and Gallbladder: Is It a Waste of Expertise and Hospital Resources?

Ramraje

Pawar

2012

Indian J Surg

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This study was undertaken to assess whether a routine histopathologic examination of two common surgical specimens (appendix and gallbladder) is needed and whether routine histopathologic examination has an impact on further management of patients. Histopathology reports of patients who had undergone appendicectomy and cholecystectomy, between 2006 and 2010, were analyzed retrospectively in the department of pathology of a tertiary care hospital. The case notes were retrieved in all cases of malignancies. Patients having a clinical diagnosis or suspicion of malignancy were excluded. The incidence and impact of unexpected pathologic diagnosis on postoperative management were noted. The study period included a total of 1,123 and 711 appendicectomy and cholecystectomy specimens, respectively. Fifteen (1.336 %) cases of appendicectomy specimens revealed incidental unexpected pathological diagnoses, which included tubercular appendicitis (n0 2), parasite (n 08), neuroma (n 01), carcinoid (n 02), pseudomyxoma (n 01), and adenocarcinoma (n 01). About 88 % of such unexpected appendiceal findings had an impact on postoperative treatment. Unexpected pathologic gallbladder findings were found in 12 (1.68 %) of 711 cholecystectomy specimens. In 6 (0.84 %) cases, gallbladder cancer (GBC) was detected. Additional further management was required in 50 % of patients with unexpected gallbladder findings. Twenty of the total 1,834 specimens (1.090 %) had an impact on patient management or outcome and were not suspected on macroscopic examination at the time of surgery. These would have been missed had the specimens not been examined microscopically. The intraoperative diagnosis of the surgeon is therefore sometimes doubtful in detecting abnormalities of the appendix and gallbladder. This study supports the sending of all appendicectomy and cholecystectomy specimens for routine histopathological examination. Appendix and gallbladder should undergo routine histopathological examination. This is important in patients with advanced age and gallstones. Also, it is of great value in identifying unsuspected conditions which require further postoperative management. Selectively sending specimens for histopathological examination can result in reduced workload on the histopathology department without compromising patient safety.

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“…N. T. Damor et al (14) and Khanna et al (19) reported that majority of non-neoplastic lesions of Gallbladder occurred in 3rd to 5th decades. While Bazoua et al (20) studied that neoplastic lesions developed in patients of age more than 50 yrs and maximum in age group 50 to 70 years. In the present study lesions of gallbladder were most common in the 4th and 5th decades.…”

Section: Discussionmentioning

confidence: 99%

Histopathological Study of Cholecystectomy Specimens in Tertiary Care Centre - Two Year Study

Yadav¹

2017

jmscr

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Do we need histology for a normal-looking gallbladder?

Abstract: A selective policy rather than routine histological examination of nonfibrotic or thickened-wall gallbladder has to be considered. This will reduce the burden on pathology departments, with significant cost savings.

Cited by 71 publications

References 21 publications

Study of Various Histopathological Lesions In Resected Gall Bladder Specimen: A Study In Consecutive 898 Cholecystectomies

Study of Various Histopathological Lesions In Resected Gall Bladder Specimen: A Study In Consecutive 898 Cholecystectomies

Routine Histopathologic Examination of Two Common Surgical Specimens—Appendix and Gallbladder: Is It a Waste of Expertise and Hospital Resources?

Histopathological Study of Cholecystectomy Specimens in Tertiary Care Centre - Two Year Study

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