Routine histopathological examination of gallbladder specimens after cholecystectomy: Is it time to change the current practice?

Benkhadoura, Mohamed; Elshaikhy, Akrem; Eldruki, Soad; Elfaedy, Osama

doi:10.5152/turkjsurg.2018.4126

Cited by 4 publications

(11 citation statements)

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“…An additional 18 studies were identified during manual cross‐referencing, resulting in a total of 73 articles, including 232 155 patients, that were eligible for data analysis. These studies were then divided into those performed in countries with a low incidence (39) 6,18–55 and countries with a high incidence (34) 7,56–88 of GBC. Characteristics of all included studies are presented in Table S1 (supporting information).…”

Section: Resultsmentioning

confidence: 99%

“…5). Three studies 23,28,52 (5633 patients) from countries with a low incidence of GBC in which the surgeon systematically De Zoysa et al 20 Almuslamani et al 22 Genç et al 23 Ghimire et al 24 Byars and Pursnani 25 Cavallaro et al 26 Chin et al 27 Romero-González et al 28 Bawahab et al 29 De Werra et al 30 Ferrarese et al 31 Koshenkov et al 32 Ozgur et al 33 Panebianco et al 34 Elshaer et al 35 Ghnnam et al 36 van Vliet et al 6 Amiraslanov et al 37 Bali et al 38 Emmett et al 39 Lilic et al 40 Basak et al 41 Düzköylü et al 43 Patel et al 44 Al-Qahtani et al 45 Tatli et al 46 Uysal et al 47 Wrenn et al 48 Al Manasra et al 49 Benkhadoura et al 50 Charfi et al 51 Corten et al 52 Dincel et al 53 Geramizadeh et al 54 Olthof et al 55 456 of 129 059 Total Heterogeneity:…”

Section: Incidence Of Truly Incidental Gallbladder Cancermentioning

confidence: 99%

“…As a result, data for 176 (39⋅3 per cent) of 448 patients with truly incidental GBC were pooled ( Table 1). T category was known in 132 De Zoysa et al 20 Lohsiriwat et al 18 Almuslamani et al 22 Genç et al 23 Ghimire et al 24 Byars and Pursnani 25 Cavallaro et al 26 Chin et al 27 Romero-González et al 28 Ozgur et al 33 Panebianco et al 34 Ghnnam et al 36 van Vliet et al 6 Amiraslanov et al 37 Basak et al 41 Ben Slama et al 42 Düzköylü et al 43 Patel et al 44 Tatli et al 46 Benkhadoura et al 50 Corten et al 52 Dincel et al 53 Mitrovic et al 21 A random-effects model was used for meta-analysis. Incidence rates are shown with 95 per cent confidence intervals.…”

Section: Clinical Consequences Of Truly Incidental Gallbladder Cancermentioning

confidence: 99%

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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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Section: Resultsmentioning

confidence: 99%

Section: Incidence Of Truly Incidental Gallbladder Cancermentioning

confidence: 99%

Section: Clinical Consequences Of Truly Incidental Gallbladder Cancermentioning

confidence: 99%

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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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“…All of the studies included in the review are in the English language and conducted in countries with a different incidence of GBC. These studies have been conducted in Asia and Europe except for one study in Mexico (Romero et al, 2012) and the other in Libya (Benkhadoura et al, 2019). These studies mainly focus The Newcastle Ottawa scale rates studies according to the selection, comparability and outcome assessment with a score range from 0 to 9.…”

Section: Study Characterizationmentioning

confidence: 99%

Selective or Routine Histology of Cholecystectomy Specimens for Diagnosing Incidental Carcinoma of Gallbladder and Correlation with Careful Intraoperative Macroscopic Examination? A Systematic Review

Khan

Rashikh

Rehman

et al. 2021

Asian Pac J Cancer Prev

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Background: Selective or Routine histology of cholecystectomy specimens for benign gallbladder disease has always been a matter of debate because of the low prevalence and bad prognosis associated with gall bladder carcinoma. The objective of this study is to ascertain whether selective histology can be preferred over Routine histology without any harm. Methods: This systematic review is conducted according to PRISMA's checklist; relevant articles were searched in the database until September 1 2020 in PubMed, Scopus, Science Direct, and Web of Science databases, manually, with search queries and without date restrictions. Studies included in this systematic review involved patients who underwent cholecystectomy for benign gallbladder disease and were diagnosed with gallbladder carcinoma incidentally either after selective or routine histology of the gallbladder. Results: A total of 24 routine or selective histology recommending studies were selected for the systematic review after following the inclusion and exclusion criteria. These studies comprised 77,213 numbers of patients and 486 numbers of Malignancies. These studies correlate the number of IGBC diagnosed histologically with the number of IGBC's that were suspected by the surgeons intraoperative by macroscopy. Routine recommending studies show a significant number of IGBC diagnosed histologically as missed by surgeons whereas the selective recommending studies show most of the histologically diagnosed IGBC already suspected by the surgeons intraoperative. When comparing the macroscopic details of the IGBC's between routine and selective studies, we found that there was significant overlap. Most of the findings missed by the surgeons as suspicious in routine studies were suspected by the surgeons involved in selective histology recommending studies. Thereby, favouring selective histology and emphasizing the need for careful intraoperative macroscopy for suspecting IGBC. Conclusion: Selective Histological examination of cholecystectomy specimens can be preferred if a careful intraoperative macroscopic examination is done and patient risk factors are taken into consideration.

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“…Incidental gallbladder carcinoma is found in 0.2%–2.9% of all cholecystectomies performed for gallstone disease 16. Adenocarcinoma accounts for almost 90% of GBC 12 14…”

Section: Discussionmentioning

confidence: 99%

Carcinoma of the gallbladder presenting as haemorrhagic cholecystitis

et al. 2020

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Routine histopathological examination of gallbladder specimens after cholecystectomy: Is it time to change the current practice?

Cited by 4 publications

References 0 publications

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

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

Selective or Routine Histology of Cholecystectomy Specimens for Diagnosing Incidental Carcinoma of Gallbladder and Correlation with Careful Intraoperative Macroscopic Examination? A Systematic Review

Carcinoma of the gallbladder presenting as haemorrhagic cholecystitis

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