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 journalArticleAcademicpeer-review

2 Citations (Web of Science)

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 languageEnglish
Pages (from-to)572-576
Number of pages5
JournalEuropean Journal of Surgical Oncology
Volume46
Issue number4 Pt A
DOIs
Publication statusPublished - Apr 2020

Keywords

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

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