Histological examination of the gallbladder following routine cholecystectomy? A selective analysis is justified.
Eur J Surg Oncol
; 46(4 Pt A): 572-576, 2020 04.
Article
en En
| MEDLINE
| ID: mdl-31753427
ABSTRACT
BACKGROUND:
It was hitherto common practice to analyse each removed gallbladder for the presence of gall bladder cancer (GBC) although this approach may be questioned. The aim of this study was to determine whether a policy of selective histopathological analysis (Sel-HPA) is oncologically safe and cost effective.METHODS:
This retrospective study was conducted in a single Dutch teaching hospital. Immediately following cholecystectomy, the surgeon decided on the basis of inspection and palpation whether histological examination was indicated. The Dutch Comprehensive Cancer Organisation (IKNL) registry was used to identify the number of GBC during this time period.RESULTS:
Of 2271 patients who underwent a cholecystectomy in our institution between January 2012 and December 2017, 1083 (47.7%) were deemed indicated for histopathological analysis. Sixteen pathological gallbladders (1.5%) were identified in that period (intestinal metaplasia, nâ¯=â¯3; low grade dysplasia nâ¯=â¯7; carcinoma nâ¯=â¯6). During follow-up, no patient was found to have GBC recurrence in the population whose gallbladder was not sent for pathology (52.3%, nâ¯=â¯1188, median 49 months of follow up). The percentage of gallbladders that were analysed decreased over the six years of observation from 83% to 38%. Our policy of Sel-HP saved over 65 000.CONCLUSIONS:
A policy of selective histopathology after cholecystectomy is oncologically safe and reduces costs.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Pólipos
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Colecistectomía
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Carcinoma
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Vesícula Biliar
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Enfermedades de la Vesícula Biliar
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Neoplasias de la Vesícula Biliar
Tipo de estudio:
Observational_studies
/
Prognostic_studies
Límite:
Adolescent
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Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
País/Región como asunto:
Europa
Idioma:
En
Revista:
Eur J Surg Oncol
Asunto de la revista:
NEOPLASIAS
Año:
2020
Tipo del documento:
Article