Method for adequate macroscopic gallbladder examination after cholecystectomy.

Area of Science:

• Surgical Pathology
• Gastrointestinal Surgery

Background:

• Lack of standardized guidelines for gallbladder macroscopic examination.
• Surgeons often rely on ad-hoc methods for gallbladder inspection.
• Need for a structured approach to improve diagnostic accuracy.

Purpose of the Study:

• To describe a practical surgical method for adequate macroscopic inspection of the gallbladder.
• To provide guidance for surgeons on gallbladder examination protocols.
• To facilitate selective histopathologic policies.

Main Methods:

• Development of a collaborative method by surgeons and pathologists.
• Retrospective review of cholecystectomies and histopathologic examinations (2006-2017).
• Analysis of gallbladder cancer incidence using the Netherlands Cancer Registry (NCR).

Main Results:

• Implementation of a selective policy led to a decrease in histopathologic examinations from 83% to 38%.
• Gallbladder cancer incidence remained stable (0.17% vs. 0.26%) during the study period.
• 2271 surgical macroscopic gallbladder examinations were performed post-implementation.

Conclusions:

• A simple, valid, and easy-to-implement method for macroscopic gallbladder analysis is presented.
• The described method supports surgeons in performing adequate gallbladder inspections.
• This approach aids in optimizing histopathologic examination protocols.