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Do we need histology for a normal-looking gallbladder?

  • Original articles
  • Published:
Journal of Hepato-Biliary-Pancreatic Surgery

Abstract

Background/Purpose

Gallbladder cancer (GBC) is a rare malignancy with poor overall prognosis. Simple cholecystectomy is curative if the cancer is limited to mucosa. We aimed here to investigate the need for routine histological examination of gallbladder.

Methods

We carried out a retrospective review of 2890 final pathology reports of processed gallbladder specimens following cholecystectomy due to gallstones disease. The review covered the 10-year period from 1994 to 2004. The notes of all cases of gallbladder cancer were scrutinized, with particular emphasis on presentation, preoperative diagnostic tools using abdominal ultrasound and computed tomography scan, operative findings, and the histology results.

Results

Gallbladder cancer (GBC) was detected in five specimens (0.17%), dysplasia in six (0.2%), and secondaries to gallbladder in three (0.1%). Histological findings confirmed gallstone disease in 97% and rare benign pathology in 3%. The median age of patients with GBC was 61 years (range, 59–84 years). In all five patients, cancer was isolated from thickened fibrotic wall on macroscopic appearance and spread through all layers of the gallbladder wall. The percentage of thickened-wall gallbladder in this study was 38.02% and the cancer incidence in the thickened wall was 0.45%.

Conclusions

A selective policy rather than routine histological examination of nonfibrotic or thickened-wall gallbladder has to be considered. This will reduce the burden on pathology departments, with significant cost savings.

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Author information

Author notes

  1. George Bazoua

    Present address: Department of General Surgery, Royal Gwent Hospital, Newport, South Wales, NP20 2UB, UK

Authors and Affiliations

  1. Department of General Surgery, Royal Gwent Hospital, Newport, South Wales, NP20 2UB, UK

    Taha Lazim

  2. University Department of Surgery, Manchester Royal Infirmary, Manchester, UK

    Numan Hamza

Authors
  1. George Bazoua
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  2. Numan Hamza
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  3. Taha Lazim
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Additional information

Presented at the Welsh Surgical Society, Pembrokeshire College, Haverfordwest, May 12–13, 2005.

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Bazoua, G., Hamza, N. & Lazim, T. Do we need histology for a normal-looking gallbladder?. J Hepatobiliary Pancreat Surg 14, 564–568 (2007). https://doi.org/10.1007/s00534-007-1225-6

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  • DOI: https://doi.org/10.1007/s00534-007-1225-6

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