Abstract
Background. Laparoscopic cholecystectomy is considered to be gold standard for symptomatic gall stones. As a routine every specimen is sent for histopathological examination postoperatively. Incidentally finding gall bladder cancers in those specimens is around 0.5–1.1%. The aim of this study is to identify those preoperative and intraoperative factors in patients with incidental gall bladder cancer to reduce unnecessary work load on pathologist and cost of investigation particularly in a developing world. Methods. Retrospective records were analyzed from January 2005 to February 2015 in a surgical unit. Demographic data, preoperative imaging, peroperative findings, macroscopic appearance, and histopathological findings were noted. Gall bladder wall was considered to be thickened if ≥3 mm on preoperative imaging or surgeons comment (on operative findings) and histopathology report. AJCC TNM system was used to stage gall bladder cancer. Results. 973 patients underwent cholecystectomy for symptomatic gallstone disease. Gallbladder carcinoma was incidentally found in 11 cases. Macroscopic abnormalities of the gallbladder were found in all those 11 patients. In patients with a macroscopically normal gallbladder, there were no cases of gallbladder carcinoma. Conclusion. Preoperative and operative findings play a pivotal role in determining incidental chances of gall bladder malignancy.
Highlights
Most of the general surgery cases are of gallstone disease
One of the studies done by Royal College of Pathologist suggests that it is mandatory to submit all gall bladder specimens for histopathology as many significant pathologies can present with normal morphological appearance [3]
This study aims to identify those preoperative and intraoperative features in patients diagnosed with incidental gall bladder cancer on histopathology to reduce unnecessary work load on pathologist and cost of investigation in developing world
Summary
Most of the general surgery cases are of gallstone disease. It affects 15% of western world, having an annual incidence of 1 in 200 [1]. Laparoscopic cholecystectomy is a recommended gold standard treatment for symptomatic gall stone patients [2]. One of the studies done by Royal College of Pathologist suggests that it is mandatory to submit all gall bladder specimens for histopathology as many significant pathologies can present with normal morphological appearance [3]. Finding malignancy in gallbladder specimen is around 0.5– 1.1%, whereas gall stones were present in 74–92% of patients with gall bladder malignancies [4, 5]. Finding gall bladder cancers in those specimens is around 0.5–1.1%. Gall bladder wall was considered to be thickened if ≥3 mm on preoperative imaging or surgeons comment (on operative findings) and histopathology report. Preoperative and operative findings play a pivotal role in determining incidental chances of gall bladder malignancy
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