Gallbladder selection for histopathological analysis based on a simple method: a prospective comparative study

Area of Science:

• Surgical Pathology
• Oncology
• Gastroenterology

Background:

• Traditional practice involves pathological analysis of all resected gallbladders post-cholecystectomy.
• Emerging evidence suggests selective analysis may be feasible.
• This study aimed to validate a method for selecting gallbladders for pathological review.

Purpose of the Study:

• To introduce and evaluate a straightforward method for surgeon-performed macroscopic gallbladder analysis (MGAS).
• To determine the utility of MGAS in identifying gallbladders that require further pathological examination.
• To potentially streamline the diagnostic workflow and reduce healthcare costs.

Main Methods:

• A prospective comparative study involving 150 patients undergoing cholecystectomy.
• Two diagnostic approaches were compared: patient variables plus MGAS, and traditional pathological analysis.
• MGAS involved macroscopic examination by the surgeon to detect abnormalities.

Main Results:

• The study included 150 patients (132 female, 18 male), predominantly under 60 years old.
• Macroscopic gallbladder analysis by the surgeon (MGAS) identified abnormalities in 30 patients (20%).
• A significant proportion, 81 patients (54%), presented with one or more risk factors for gallbladder cancer.

Conclusions:

• Surgeon-performed macroscopic gallbladder analysis (MGAS) is a viable method for initial gallbladder assessment post-cholecystectomy.
• MGAS can aid in selecting gallbladders that warrant detailed pathological examination, potentially optimizing resource allocation.
• This approach may help differentiate between gallbladders with and without concerning features, guiding further diagnostic steps.