B J G A Corten1, S Alexander2, P H van Zwam3, W K G Leclercq2, R M H Roumen2, G D Slooter2. 1. Department of Surgery, Máxima Medical Center, PO Box 7777, 5500 MB, Veldhoven, The Netherlands. bartcorten@gmail.com. 2. Department of Surgery, Máxima Medical Center, PO Box 7777, 5500 MB, Veldhoven, The Netherlands. 3. Department of Pathology, PAMM Laboratory for Pathology and Medical Microbiology, Eindhoven, The Netherlands.
Abstract
INTRODUCTION: Routine histopathologic gallbladder examination after cholecystectomy has been a point of discussion. The aim of this study was to evaluate the macroscopic examination by the surgeon in relation to the final histology. METHODS: A prospective study was conducted to investigate the practice of macroscopic gallbladder examination by a surgeon compared to routine histopathology by a pathologist. All consecutive cholecystectomies were included between November 2009 and February 2011. RESULTS: A total of 319 consecutive cholecystectomies were performed. Of all macroscopic examinations, the surgeon identified 62 gallbladders with macroscopic abnormalities, ranging from polyps to wall thickening or ulcers. In 55 (17.2%) cases, the surgeon judged that further examination of the specimen by the pathologist could possibly lead to additional and relevant findings. There was a strong agreement between the surgeon and the pathologist concerning the macroscopic examination (κappa = 0.822). The surgeon and the pathologist had disagreement on the macroscopic examination of 18 gallbladders, without clinical consequences for the patient. DISCUSSION: The present prospective study shows that the surgeon should be able to select those gallbladders needing a microscopic gallbladder examination. Potentially, about 80% of this kind of routine histology can be reduced.
INTRODUCTION: Routine histopathologic gallbladder examination after cholecystectomy has been a point of discussion. The aim of this study was to evaluate the macroscopic examination by the surgeon in relation to the final histology. METHODS: A prospective study was conducted to investigate the practice of macroscopic gallbladder examination by a surgeon compared to routine histopathology by a pathologist. All consecutive cholecystectomies were included between November 2009 and February 2011. RESULTS: A total of 319 consecutive cholecystectomies were performed. Of all macroscopic examinations, the surgeon identified 62 gallbladders with macroscopic abnormalities, ranging from polyps to wall thickening or ulcers. In 55 (17.2%) cases, the surgeon judged that further examination of the specimen by the pathologist could possibly lead to additional and relevant findings. There was a strong agreement between the surgeon and the pathologist concerning the macroscopic examination (κappa = 0.822). The surgeon and the pathologist had disagreement on the macroscopic examination of 18 gallbladders, without clinical consequences for the patient. DISCUSSION: The present prospective study shows that the surgeon should be able to select those gallbladders needing a microscopic gallbladder examination. Potentially, about 80% of this kind of routine histology can be reduced.
Authors: Caroline D M Witjes; Sanne A W van den Akker; Otto Visser; Henrike E Karim-Kos; Esther de Vries; Jan N M Ijzermans; Robert A de Man; Jan Willem W Coebergh; Cornelis Verhoef Journal: Dig Surg Date: 2012-03-22 Impact factor: 2.588
Authors: Philippe Marc Glauser; Daniel Strub; Samuel Andreas Käser; Diana Mattiello; Franziska Rieben; Christoph Andreas Maurer Journal: Surg Endosc Date: 2010-02-23 Impact factor: 4.584
Authors: Vivian P Bastiaenen; Bartholomeus Jga Corten; Elise Aj de Savornin Lohman; Joske de Jonge; Anne C Kraima; Hilko A Swank; Jaap Lp van Vliet; Gijs Jd van Acker; Anna Aw van Geloven; Klaas H In 't Hof; Lianne Koens; Philip R de Reuver; Charles C van Rossem; Gerrit D Slooter; Pieter J Tanis; Valeska Terpstra; Marcel Gw Dijkgraaf; Willem A Bemelman Journal: BMJ Open Date: 2019-12-23 Impact factor: 2.692
Authors: V P Bastiaenen; J E Tuijp; S van Dieren; M G Besselink; T M van Gulik; L Koens; P J Tanis; W A Bemelman Journal: Br J Surg Date: 2020-07-08 Impact factor: 6.939