Incidental gallbladder carcinoma in laparoscopic cholecystectomy: Five years local experience

Ghnnam, Wagih Mommtaz; Elbeshry, Turki Maed Al Salem; Malek, Jaweed Rafiq; Emarra, Emad Shebl; Alzahrany, Mohammed Eid; Alqarni, Ahmad Ali; Khattab, Ammar Ahmad

doi:10.18035/emj.v2i2.67

Cited by 6 publications

(16 citation statements)

References 34 publications

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“…None of the pts in T1 stage carcinoma had perineural invasion. Similar results were obtained in studies by Siddiqui and Ghnnam et al [10,14].…”

Section: Discussionsupporting

confidence: 91%

“…The mean age of incidental carcinoma detection in our study was 57.8 years, however, in other studies from various parts of world including Saudi, Japan, China and Italy the mean age of presentation is higher than 65 years [7,11,13,14]. The youngest male patient affected in our study group was 32 years and on re-exploration surgery he had liver involvement.…”

Section: Discussioncontrasting

confidence: 60%

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Incidental Detection of Carcinoma Gall Bladder in Laparoscopic Cholecystectomy Specimens: A Thirteen Year Study of 23 Cases and Literature Review

Gulwani

Gupta

Kaur

2015

Indian J Surg Oncol

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Carcinoma of gall bladder is the most common malignancy of the biliary tract worldwide and is usually associated with poor prognosis. In this era of laparoscopic cholecystectomy, there has been increase in detection of early stage incidental gall bladder carcinoma in cholecystectomy specimens. A retrospective study was carried out in tertiary care hospital in central India. A total of 2990 patients underwent laparoscopic cholecystectomy during the year 2001-2013. Hospital records and histopathology reports of these patients were studied in detail. Twenty three cases of gall bladder carcinoma were detected incidentally accounting for an incidence of 0.76 %. It was more common in females with an M: F ratio of 1:1.9. Mean age of presentation was 57.8 years. Gall stones were present in 22 cases and one patient presented with features of acute cholecystitis. Three patients had associated xanthogranulomatous inflammation and 10 had associated intestinal metaplasia. It is not uncommon to encounter incidental malignancies of gall bladder in laparoscopic cholecystectomy specimens sent to histopathology for presumably benign disease. Histopathology reports must include comments on extent of infiltration, perineural invasion, tumor differentiation and nodal involvement for oncologist information and subsequent management of patients.

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“…None of the pts in T1 stage carcinoma had perineural invasion. Similar results were obtained in studies by Siddiqui and Ghnnam et al [10,14].…”

Section: Discussionsupporting

confidence: 91%

Section: Discussioncontrasting

confidence: 60%

Incidental Detection of Carcinoma Gall Bladder in Laparoscopic Cholecystectomy Specimens: A Thirteen Year Study of 23 Cases and Literature Review

Gulwani

Gupta

Kaur

2015

Indian J Surg Oncol

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“…1,5 The incidence of IGBC as given in literatures ranges from 0.19% to 3.13% of all cholecystectomies. 4,6 Gall bladder stones and chronic inflammation of the wall are common risk factors for this tumor. Around 90% of GBC have accompanying cholelithiasis, however only 0.5-3% of patients with cholelithiasis develop GBC.…”

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confidence: 99%

“…Around 90% of GBC have accompanying cholelithiasis, however only 0.5-3% of patients with cholelithiasis develop GBC. [5][6][7][8] GBC is an aggressive and lethal malignancy with a dismal prognosis. The anatomic location, the non-specificity of signs and symptoms, the aggressive course of the malignancy all contribute to a late presentation at an advanced stage.…”

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confidence: 99%

“…The anatomic location, the non-specificity of signs and symptoms, the aggressive course of the malignancy all contribute to a late presentation at an advanced stage. 5,6 Thus, histopathological analysis of cholecystectomy specimens provide important information about the diagnosis for further line of management. The aim of the present study is to report our experience with incidental gall bladder carcinoma (IGBC) diagnosed during histopathological examination of cholecystectomy specimens removed for cholelithiasis.…”

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confidence: 99%

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Incidental Gall Bladder Carcinoma (IGBC) in Cholecystectomy Specimens Removed for Cholelithiasis- A Single Centre Experience

Pukhrambam¹,

Shimray²,

Laishram³

et al. 2019

jebmh

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BACKGROUND Carcinoma of the gallbladder is the most common malignancy of the biliary tract. The indistinguishable clinical manifestations of cholelithiasis and cholecystitis may mask an underlying malignancy. The present study highlights the occurrence of Incidental gallbladder carcinoma (IGBC) detected during histopathological examination in cholecystectomy specimens removed for cholelithiasis. METHODS This is a tertiary hospital based cross-sectional study of 2379 cholecystectomy specimens removed during cholelithiasis over a ten-year period. Relevant hospital records, histopathology slides and reports were reviewed, re-evaluated and studied. RESULTS Eleven (11) cases of IGBC, constituting 0.46% were diagnosed. Females with IGBC were more than the males (M:F=1:4.5). Focally thickened wall (mean wall thickness of 0.57 cm) was the most common gross finding with 100% association with cholelithiasis. Moderately differentiated Adenocarcinoma was the most common histological type and more than 70% were in lower stage (3 cases in pT1 and 5 cases in pT2) while the remaining 3 cases were at a higher stage with positive margins. CONCLUSIONS Early detection of IGBC by histopathological examination would have a favourable impact on prognosis and management thereby increasing the survival outcome.

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Safe, selective histopathological examination of gallbladder specimens: a systematic review

Bastiaenen

Tuijp

Besselink

et al. 2020

British Journal of Surgery

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Background Routine histopathological examination after cholecystectomy is costly, but the prevalence of unsuspected gallbladder cancer (incidental GBC) is low. This study determined whether selective histopathological examination is safe. Methods A comprehensive search of PubMed, Embase, Web of Science and the Cochrane Library was performed. Pooled incidences of incidental and truly incidental GBC (GBC detected during histopathological examination without preoperative or intraoperative suspicion) were estimated using a random‐effects model. The clinical consequences of truly incidental GBC were assessed. Results Seventy‐three studies (232 155 patients) were included. In low‐incidence countries, the pooled incidence was 0·32 (95 per cent c.i. 0·25 to 0·42) per cent for incidental GBC and 0·18 (0·10 to 0·35) per cent for truly incidental GBC. Subgroup analysis of studies in which surgeons systematically examined the gallbladder revealed a pooled incidence of 0·04 (0·01 to 0·14) per cent. In high‐incidence countries, corresponding pooled incidences were 0·83 (0·58 to 1·18), 0·44 (0·21 to 0·91) and 0·08 (0·02 to 0·39) per cent respectively. Clinical consequences were reported for 176 (39·3 per cent) of 448 patients with truly incidental GBC. Thirty‐three patients (18·8 per cent) underwent secondary surgery. Subgroup analysis showed that at least half of GBC not detected during the surgeon's systematic examination of the gallbladder was early stage (T1a status or below) and of no clinical consequence. Conclusion Selective histopathological examination of the gallbladder after initial macroscopic assessment by the surgeon seems safe and could reduce costs.

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Incidental gallbladder carcinoma in laparoscopic cholecystectomy: Five years local experience

Cited by 6 publications

References 34 publications

Incidental Detection of Carcinoma Gall Bladder in Laparoscopic Cholecystectomy Specimens: A Thirteen Year Study of 23 Cases and Literature Review

Incidental Detection of Carcinoma Gall Bladder in Laparoscopic Cholecystectomy Specimens: A Thirteen Year Study of 23 Cases and Literature Review

Incidental Gall Bladder Carcinoma (IGBC) in Cholecystectomy Specimens Removed for Cholelithiasis- A Single Centre Experience

Safe, selective histopathological examination of gallbladder specimens: a systematic review

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