BACKGROUND AND OBJECTIVES: Normally, the gallbladder is sent routinely for histological examination after cholecystectomy. From a cost-benefit point of view this may not be optimal. METHODS: Computerised records were used to identify patients with gallbladder carcinoma over a 20-year period, from 1979 to 1999, and these patient records were evaluated manually. RESULTS: The estimated cost for one histological examination was $37. During the period, 4,614 cholecystectomies were performed and 33 patients had gallbladder carcinoma. In 29 of the 33 patients, there was evident preoperative and/or peroperative suspicion of cancer, but no such suspicion in four patients. These four patients had other peroperative macroscopic abnormal findings, besides gallbladder stones. CONCLUSION: This retrospective series indicates that in the case of normal preoperative and/or peroperative macroscopic conditions (except for gallbladder stones) there is no need for histological examination of the gallbladder.
BACKGROUND AND OBJECTIVES: Normally, the gallbladder is sent routinely for histological examination after cholecystectomy. From a cost-benefit point of view this may not be optimal. METHODS: Computerised records were used to identify patients with gallbladder carcinoma over a 20-year period, from 1979 to 1999, and these patient records were evaluated manually. RESULTS: The estimated cost for one histological examination was $37. During the period, 4,614 cholecystectomies were performed and 33 patients had gallbladder carcinoma. In 29 of the 33 patients, there was evident preoperative and/or peroperative suspicion of cancer, but no such suspicion in four patients. These four patients had other peroperative macroscopic abnormal findings, besides gallbladder stones. CONCLUSION: This retrospective series indicates that in the case of normal preoperative and/or peroperative macroscopic conditions (except for gallbladder stones) there is no need for histological examination of the gallbladder.
Authors: Hilko A Swank; Irene M Mulder; Wim C Hop; Marc J van de Vijver; Johan F Lange; Willem A Bemelman Journal: Surg Endosc Date: 2013-07-23 Impact factor: 4.584