SP7.6 Do we need Routine Histopathological Examination of Gall Bladder Specimens after Cholecystectomy?

Abstract

Abstract Aims Gall bladder diseases usually manifest as gall stones, inflammation of gall bladder and gall bladder cancer. There had been a constant debate over the years regarding selective vs. routine histopathological assessment of all gall bladder specimens. This study was aimed to assess the safety of adopting the policy of selective histopathological examination of those gall bladder specimens with pre-operative and/or intra-operative suspicion of malignancy without risking patient safety. Methodology A descriptive, cross-sectional study was conducted. All 1285 cases of gall bladder biopsies done after elective cholecystectomies, during a period of 2 years from 1st January, 2018 to 31st December 2019, were reviewed retrospectively. Results During the study period, a total of 1285 gall bladder specimens were submitted for histopathological analysis. Chronic cholecystitis was found in 1020 (79.3%) patients, acute cholecystitis in 198 (15.4%), gangrenous gall bladder in 19 (1.47%) patients and gall bladder carcinoma (GBC) in 26 (2.02%) patients. Pre-operative or intraoperative diagnosis of GBC was made in 22/26 patients. The remaining 4 patients had either stage Tis or T1 stage carcinoma and did not require revision surgery. Conclusion In areas with low incidence of gall bladder carcinoma, a selective approach of histopathological examination of gall bladder specimens may be considered safe. Such selective approach is more economical and reduces the work burden of pathologists without risking patient safety.