HISTOPATHOLOGICAL EXAMINATION OF CHOLECYSTECTOMY SPECIMENS- ROUTINE OR SELECTIVE?
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2019, Vol 6, Issue 11
Abstract
BACKGROUND The objective of routine histopathological examination of all cholecystectomy specimens is to confirm the clinico-radiological diagnosis, identification of unsuspected findings including incidental gallbladder malignancy. This study is to assess the need for routine or selective histopathological evaluation of gallbladder specimens following cholecystectomy. We wanted to determine as to whether routine histological examination of every cholecystectomy specimen is justified. MATERIALS AND METHODS Patients undergoing cholecystectomy either by open or laparoscopic technique were included. The American Joint Committee on Cancer (AJCC) Tumour Nodal Metastasis (TNM) system was the reference for staging carcinoma gallbladder. Cholecystectomy done as a part of other surgical procedures like liver resection, Whipple procedure & prophylactic cholecystectomies done for sickle cell anaemia were excluded. RESULTS Adenocarcinoma of gallbladder was detected in 1.14%, out of 176 cases on histopathological examination. Frequency was more in females and the mean age of occurrence was 31 years. Both patients underwent open cholecystectomy and had well and moderately differentiated adenocarcinoma on histopathology respectively. CONCLUSION All cases of invasive carcinoma of the gall bladder showed macroscopic abnormal appearance either pre- or intra-operatively. A more selective policy for histological examination of the gall bladder specimens would not miss any invasive malignancy. It would significantly reduce the workload for a pathologist, be more cost-effective and still remain safe for the patients.
Authors and Affiliations
Kalisetty Suresh Babu, Kondapaturu Lakshmi Chandrasekhar, Dogga Hemanth Saikumar, Yendeti Hemraj, Kandan Nivetha
Keywords
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- EP ID EP615596
- DOI 10.18410/jebmh/2019/191
- Views 73
- Downloads 0
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