Slim Charfi1, Naourez Gouiaa2, Hela Mnif2, Lassaad Chtourou3, Nabil Tahri3, Bassem Abid4, Rafik Mzali4, Tahya Sellami Boudawara2. 1. Department of Pathology, CHU Habib Bourguiba, Sfax 3029, Tunisia; Sfax Medical School, University of Sfax, Sfax 3029, Tunisia. Electronic address: charfislim@gmail.com. 2. Department of Pathology, CHU Habib Bourguiba, Sfax 3029, Tunisia; Sfax Medical School, University of Sfax, Sfax 3029, Tunisia. 3. Sfax Medical School, University of Sfax, Sfax 3029, Tunisia; Department of Gastroenterology, CHU Habib Bourguiba, Sfax 3029, Tunisia. 4. Sfax Medical School, University of Sfax, Sfax 3029, Tunisia; Department of Surgery, CHU Habib Bourguiba, Sfax 3029, Tunisia.
Abstract
BACKGROUND: The histopathological examination of cholecystectomy specimens has not been standardized with a debate concerning the routine and the selective approach. The aim of this study was to assess the information obtained from routine histopathological examination of cholecystectomy specimens. METHODS: All histopathological reports of cholecystectomy specimens between January 2003 and December 2016 were analyzed, including a clinical diagnosis of benign gallstone disease or cholecystitis. RESULTS: A total of 20,584 reports were examined. The mean age of patients was 54.2 years. Patients aged more than 60 years represent 37.6% of the study population. Of all patients, 15,973 (77.6%) were females. Incidental gallbladder cancers (GBC) were present in 155 cholecystectomies specimens (0.8%). 67.1% of GBC are at T2 and T3 stage. Granulomatous cholecystitis was diagnosed in only 19 cases (0.1%). GBC were more prevalent in older patients (P < 10-6) and cholesterolosis was more prevalent in young patients (P < 10-6). There was no gender predilection for GBC (P = 0.739). CONCLUSIONS: The rate of incidental gallbladder carcinoma in our study is low, yet, we found a higher proportion of T2 and T3 carcinomas stage. Granulomatous cholecystitis may need further investigations and treatments. When a selective approch of histopathological examination of cholecystectomy specimens is used, it is important to take into account that clinical parameters are significantly associated with gallbladder cancer.
BACKGROUND: The histopathological examination of cholecystectomy specimens has not been standardized with a debate concerning the routine and the selective approach. The aim of this study was to assess the information obtained from routine histopathological examination of cholecystectomy specimens. METHODS: All histopathological reports of cholecystectomy specimens between January 2003 and December 2016 were analyzed, including a clinical diagnosis of benign gallstone disease or cholecystitis. RESULTS: A total of 20,584 reports were examined. The mean age of patients was 54.2 years. Patients aged more than 60 years represent 37.6% of the study population. Of all patients, 15,973 (77.6%) were females. Incidental gallbladder cancers (GBC) were present in 155 cholecystectomies specimens (0.8%). 67.1% of GBC are at T2 and T3 stage. Granulomatous cholecystitis was diagnosed in only 19 cases (0.1%). GBC were more prevalent in older patients (P < 10-6) and cholesterolosis was more prevalent in young patients (P < 10-6). There was no gender predilection for GBC (P = 0.739). CONCLUSIONS: The rate of incidental gallbladder carcinoma in our study is low, yet, we found a higher proportion of T2 and T3 carcinomas stage. Granulomatous cholecystitis may need further investigations and treatments. When a selective approch of histopathological examination of cholecystectomy specimens is used, it is important to take into account that clinical parameters are significantly associated with gallbladder cancer.
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