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Surgically Resected Gall Bladder: Is Histopathology Needed for All?
Vikash Talreja1, Aun Ali1, Rabel Khawaja2
1Department of Surgery, Jinnah Medical College Hospital, S. R-6, 7/A, Korangi Industrial Area, Karachi-74900, Pakistan.
Surgery Research and Practice
|April 29, 2016
Summary
Preoperative and operative findings are key to identifying incidental gallbladder cancer during routine cholecystectomy for gallstones. Macroscopic abnormalities predict malignancy, potentially reducing pathologist workload.
Area of Science:
- Surgical Oncology
- Gastroenterology
- Pathology
Background:
- Laparoscopic cholecystectomy is standard for symptomatic gallstones.
- Incidental gallbladder cancer is found in 0.5-1.1% of specimens.
- Reducing unnecessary histopathological examinations is crucial, especially in developing nations.
Purpose of the Study:
- Identify preoperative and intraoperative factors for incidental gallbladder cancer.
- Minimize pathologist workload and investigation costs.
- Improve diagnostic accuracy for gallbladder malignancy.
Main Methods:
- Retrospective analysis of 973 cholecystectomy records (2005-2015).
- Data collected: demographics, imaging, operative findings, macroscopic and histopathological results.
- Gallbladder wall thickness (≥3mm) and AJCC TNM staging were assessed.
Main Results:
- Gallbladder carcinoma was incidentally detected in 11 of 973 patients.
- All 11 patients with incidental cancer had macroscopic gallbladder abnormalities.
- No gallbladder cancers were found in patients with macroscopically normal gallbladders.
Conclusions:
- Preoperative and operative findings are critical for detecting incidental gallbladder cancer.
- Macroscopic gallbladder appearance is a significant indicator of malignancy.
- This approach can help streamline investigations and reduce costs.
