Histological examination of the gallbladder following routine cholecystectomy?: A selective analysis is justified

B J G A Corten; W K G Leclercq; R M H Roumen; P H van Zwam; C H Dejong; G D Slooter

doi:10.1016/j.ejso.2019.11.497

Histological examination of the gallbladder following routine cholecystectomy? A selective analysis is justified

B J G A Corten^*, W K G Leclercq, R M H Roumen, P H van Zwam, C H Dejong, G D Slooter

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

BACKGROUND: It was hitherto common practice to analyse each removed gallbladder for the presence of gall bladder cancer (GBC) although this approach may be questioned. The aim of this study was to determine whether a policy of selective histopathological analysis (Sel-HPA) is oncologically safe and cost effective.

METHODS: This retrospective study was conducted in a single Dutch teaching hospital. Immediately following cholecystectomy, the surgeon decided on the basis of inspection and palpation whether histological examination was indicated. The Dutch Comprehensive Cancer Organisation (IKNL) registry was used to identify the number of GBC during this time period.

RESULTS: Of 2271 patients who underwent a cholecystectomy in our institution between January 2012 and December 2017, 1083 (47.7%) were deemed indicated for histopathological analysis. Sixteen pathological gallbladders (1.5%) were identified in that period (intestinal metaplasia, n = 3; low grade dysplasia n = 7; carcinoma n = 6). During follow-up, no patient was found to have GBC recurrence in the population whose gallbladder was not sent for pathology (52.3%, n = 1188, median 49 months of follow up). The percentage of gallbladders that were analysed decreased over the six years of observation from 83% to 38%. Our policy of Sel-HP saved over €65 000.

CONCLUSIONS: A policy of selective histopathology after cholecystectomy is oncologically safe and reduces costs.

Original language	English
Pages (from-to)	572-576
Number of pages	5
Journal	European Journal of Surgical Oncology
Volume	46
Issue number	4 Pt A
DOIs	https://doi.org/10.1016/j.ejso.2019.11.497
Publication status	Published - Apr 2020

Keywords

Cholecystectomy
Gallbladder carcinoma
Gallbladder cancer
Routine histopathologic examination
Selective histopathologic examination
HISTOPATHOLOGICAL EXAMINATION
GALL-BLADDER
SPECIMENS
CARCINOMA

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title = "Histological examination of the gallbladder following routine cholecystectomy?: A selective analysis is justified",

abstract = "BACKGROUND: It was hitherto common practice to analyse each removed gallbladder for the presence of gall bladder cancer (GBC) although this approach may be questioned. The aim of this study was to determine whether a policy of selective histopathological analysis (Sel-HPA) is oncologically safe and cost effective.METHODS: This retrospective study was conducted in a single Dutch teaching hospital. Immediately following cholecystectomy, the surgeon decided on the basis of inspection and palpation whether histological examination was indicated. The Dutch Comprehensive Cancer Organisation (IKNL) registry was used to identify the number of GBC during this time period.RESULTS: Of 2271 patients who underwent a cholecystectomy in our institution between January 2012 and December 2017, 1083 (47.7%) were deemed indicated for histopathological analysis. Sixteen pathological gallbladders (1.5%) were identified in that period (intestinal metaplasia, n = 3; low grade dysplasia n = 7; carcinoma n = 6). During follow-up, no patient was found to have GBC recurrence in the population whose gallbladder was not sent for pathology (52.3%, n = 1188, median 49 months of follow up). The percentage of gallbladders that were analysed decreased over the six years of observation from 83% to 38%. Our policy of Sel-HP saved over €65 000.CONCLUSIONS: A policy of selective histopathology after cholecystectomy is oncologically safe and reduces costs.",

keywords = "Cholecystectomy, Gallbladder carcinoma, Gallbladder cancer, Routine histopathologic examination, Selective histopathologic examination, HISTOPATHOLOGICAL EXAMINATION, GALL-BLADDER, SPECIMENS, CARCINOMA",

author = "Corten, {B J G A} and Leclercq, {W K G} and Roumen, {R M H} and {van Zwam}, {P H} and Dejong, {C H} and Slooter, {G D}",

year = "2020",

month = apr,

doi = "10.1016/j.ejso.2019.11.497",

language = "English",

volume = "46",

pages = "572--576",

journal = "European Journal of Surgical Oncology",

issn = "0748-7983",

publisher = "W.B. Saunders Ltd",

number = "4 Pt A",

}

TY - JOUR

T1 - Histological examination of the gallbladder following routine cholecystectomy?

T2 - A selective analysis is justified

AU - Corten, B J G A

AU - Leclercq, W K G

AU - Roumen, R M H

AU - van Zwam, P H

AU - Dejong, C H

AU - Slooter, G D

PY - 2020/4

Y1 - 2020/4

N2 - BACKGROUND: It was hitherto common practice to analyse each removed gallbladder for the presence of gall bladder cancer (GBC) although this approach may be questioned. The aim of this study was to determine whether a policy of selective histopathological analysis (Sel-HPA) is oncologically safe and cost effective.METHODS: This retrospective study was conducted in a single Dutch teaching hospital. Immediately following cholecystectomy, the surgeon decided on the basis of inspection and palpation whether histological examination was indicated. The Dutch Comprehensive Cancer Organisation (IKNL) registry was used to identify the number of GBC during this time period.RESULTS: Of 2271 patients who underwent a cholecystectomy in our institution between January 2012 and December 2017, 1083 (47.7%) were deemed indicated for histopathological analysis. Sixteen pathological gallbladders (1.5%) were identified in that period (intestinal metaplasia, n = 3; low grade dysplasia n = 7; carcinoma n = 6). During follow-up, no patient was found to have GBC recurrence in the population whose gallbladder was not sent for pathology (52.3%, n = 1188, median 49 months of follow up). The percentage of gallbladders that were analysed decreased over the six years of observation from 83% to 38%. Our policy of Sel-HP saved over €65 000.CONCLUSIONS: A policy of selective histopathology after cholecystectomy is oncologically safe and reduces costs.

AB - BACKGROUND: It was hitherto common practice to analyse each removed gallbladder for the presence of gall bladder cancer (GBC) although this approach may be questioned. The aim of this study was to determine whether a policy of selective histopathological analysis (Sel-HPA) is oncologically safe and cost effective.METHODS: This retrospective study was conducted in a single Dutch teaching hospital. Immediately following cholecystectomy, the surgeon decided on the basis of inspection and palpation whether histological examination was indicated. The Dutch Comprehensive Cancer Organisation (IKNL) registry was used to identify the number of GBC during this time period.RESULTS: Of 2271 patients who underwent a cholecystectomy in our institution between January 2012 and December 2017, 1083 (47.7%) were deemed indicated for histopathological analysis. Sixteen pathological gallbladders (1.5%) were identified in that period (intestinal metaplasia, n = 3; low grade dysplasia n = 7; carcinoma n = 6). During follow-up, no patient was found to have GBC recurrence in the population whose gallbladder was not sent for pathology (52.3%, n = 1188, median 49 months of follow up). The percentage of gallbladders that were analysed decreased over the six years of observation from 83% to 38%. Our policy of Sel-HP saved over €65 000.CONCLUSIONS: A policy of selective histopathology after cholecystectomy is oncologically safe and reduces costs.

KW - Cholecystectomy

KW - Gallbladder carcinoma

KW - Gallbladder cancer

KW - Routine histopathologic examination

KW - Selective histopathologic examination

KW - HISTOPATHOLOGICAL EXAMINATION

KW - GALL-BLADDER

KW - SPECIMENS

KW - CARCINOMA

U2 - 10.1016/j.ejso.2019.11.497

DO - 10.1016/j.ejso.2019.11.497

M3 - Article

C2 - 31753427

SN - 0748-7983

VL - 46

SP - 572

EP - 576

JO - European Journal of Surgical Oncology

JF - European Journal of Surgical Oncology

IS - 4 Pt A

ER -

Histological examination of the gallbladder following routine cholecystectomy? A selective analysis is justified

Abstract

Keywords

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