The Value of Routine Histopathology After Laparoscopic Cholecystectomy: A Single-Centre Retrospective Analysis

Area of Science:

• Surgical Pathology
• Health Economics
• General Surgery

Background:

• Laparoscopic cholecystectomy is a common surgical procedure worldwide.
• The routine histopathological examination of all gallbladder specimens is standard practice in many centers.
• The clinical utility and cost-effectiveness of this routine practice are subjects of ongoing debate.

Purpose of the Study:

• To evaluate the clinical and cost-effectiveness of routine versus selective histopathological examination of gallbladder specimens.
• To determine the incidence of unexpected histopathological findings in patients undergoing laparoscopic cholecystectomy.

Main Methods:

• A retrospective observational study was conducted on 171 patients who underwent laparoscopic cholecystectomy.
• Data were collected from theatre management systems and electronic patient records.
• The study period was from July 1, 2023, to January 30, 2024.

Main Results:

• The study included 171 patients (69% female, mean age 53.1 years).
• The vast majority of specimens (99.4%) showed benign inflammatory disease.
• Only one case (0.58%) of low-grade dysplasia with clear margins was identified, requiring no further intervention.

Conclusions:

• The incidence of unexpected, clinically significant histopathological findings is very low.
• Routine histopathology for all specimens represents a significant financial burden with minimal patient benefit.
• A selective policy, guided by intraoperative assessment and patient risk factors, is a more rational and cost-effective approach.