Abstract
Objectives: To determine the incidence of incidental gallbladder cancer (IGBC) and to assess the need of routine histopathological examination of all gallbladder specimens after cholecystectomy for benign gallstone diseases
Design: Retrospective study
Setting: Department of Surgery, College of Medicine, King Saud University, KSA
Subjects: This study included all the patients who underwent elective or emergency cholecystectomy for gallstone disease at King Saud Medical City, Riyadh, Saudi Arabia between January 2012 and September 2015. Patients with preoperative suspicion of gallbladder cancer on imaging, or underwent cholecystectomy for gallbladder polyps or porcelain gallbladder were excluded from the study. Medical record of all the selected patients was reviewed and the data were collected.
Interventions: Histopathological examination of gallbladder
Main outcome measures: IGBC, routine histopathological examination of all gallbladder
Results: A total of 2396 patients underwent cholecystectomy for gallstones disease. All gallbladder specimens were sent for histopathological examination. IGBC was detected in nine gallbladder specimens (0.4%). Out of 2396 patients, morphologic abnormalities were observed in 518 specimens (22.6%). There was no reported case of IGBC with normal appearance of gallbladder specimen. Five patients underwent simple cholecystectomy for stage T1b, three patients of stage T2 tumor had further liver resection and one patient received only palliative care.
Conclusions: The incidence of IGBC was 0.38%. All cases of IGBC were detected in abnormal looking thick wall gall bladder. Therefore, selective histopathology of abnormally looking specimen is recommended to reduce the cost and work load of pathologists.