EP-10 Is selective histology of cholecystectomy specimens for benign gallbladder disease a future surgical practice?

Abstract

Abstract Cholelithiasis, known as gallstone disease, is highly prevalent in developed countries population, with symptomatic cholelithiasis being one of main indications for cholecystectomy (BMJ Best Practice, 2021). Elective or emergency laparoscopic cholecystectomy has become a gold standard with a common practice all over the world to proceed with routine histopathological examination of all gallbladder specimens. The rationale behind this established practice is to exclude the presence of incidental gallbladder malignancy (Lundgren et al., 2018). Despite being the most common cancer of the biliary tract, gallbladder cancer is a rare benign entity in developed countries. It is generally associated with a poor prognosis (Lundgren et al., 2018). Gallbladder cancer often mimics the clinical features of benign gallbladder disease with 60 to 80% (Emmett et al., 2015) of the cancers being diagnosed following cholecystectomy. Different authors have reported a low incidence of GC (0.19 to 3.3%) (Emmett et al., 2015) in cholecystostomy specimens. Therefore, recent literature reviews (Khan et al., 2021) have challenged the surgical community to change their clinical practice. They suggest a selective histopathology examination of gallbladder specimens based on patients’ risk factors and thorough intraoperative macroscopic assessment by the surgeon as a safe and cost-effective practice (Lundgren et al., 2018; Khan et al., 2021).