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ISSN: 1895-4588
Videosurgery and Other Miniinvasive Techniques
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1/2018
vol. 13
 
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abstract:
Original paper

Unexpected pathological findings after laparoscopic cholecystectomy – analysis of 1131 cases

Katarzyna Bartosiak, Maciej Liszka, Tomasz Drazba, Krzysztof Paśnik, Michal R. Janik

Videosurgery Miniinv 2018; 13 (1): 62–66
Online publish date: 2017/08/18
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Introduction
Gallbladder specimens are routinely sent for histopathological examination after cholecystectomy in order to rule out the presence of unexpected pathological findings.

Aim
To establish the overall incidence of unexpected pathological findings in patients who underwent laparoscopic cholecystectomy for symptomatic gallbladder disease and determine whether the macroscopic appearance of the gallbladder in ultrasound examination could be a valid method for identifying patients with gallbladder malignancy.

Material and methods
A retrospective study was conducted between 2013 and 2015. All histological reports (n = 1131) after cholecystectomy were searched for unexpected pathological findings. In cases where unexpected pathological findings were identified the additional analysis of preoperative abdominal ultrasound examination (USG) was done to determine the usefulness of USG in diagnosis of gallbladder malignancy.

Results
Of the 1131 patients included in the study, 356 (31.47%) were male and 774 (68.43%) were female. Unexpected pathological findings were present in 21 cases. The overall incidence of unexpected pathological findings was 1.86%. Only in 5 patients were suspicious appearances of gallbladder observed in preoperative ultrasound examination. In 16 patients there was no suspicion of malignancy. The positive predictive value of USG was 0.238.

Conclusions
The incidence of unexpected pathological findings after laparoscopic cholecystectomy was 1.86%. Ultrasonography has low positive predictive value for identifying patients with malignant findings in a gallbladder specimen.

keywords:

cholecystectomy, gallbladder, gallbladder malignancy, histopathological examination, ultrasound examination

references:
Śmigielski JA, Piskorz Ł, Koptas W. Comparison of treatment costs of laparoscopic and open surgery. Videosurgery Miniinv 2015; 10: 437-41.
Donmez T, Uzman S, Ferahman S, et al. New advantageous tool in single incision laparoscopic cholecystectomy: the needle grasper. Videosurgery Miniinv 2016; 11: 38-43.
Wroblewski T, Kobryn K, Nazarewski Ł, et al. Minilaparoscopic cholecystectomy – the new non-visible scars technique. Preliminary report of first series. Videosurgery Miniinv 2015; 10: 150-4.
Slater M, Booth MI, Dehn TCB. Cost-effective laparoscopic cholecystectomy. Ann R Coll Surg Engl 2009; 91: 670-2.
Siddiqui FG, Memon AA, Abro AH, et al. Routine histopathology of gallbladder after elective cholecystectomy for gallstones: waste of resources or a justified act? BMC Surg 2013; 13: 26.
Van Vliet JLP, Van Gulik TM, Verbeek PCM. Is it necessary to send gallbladder specimens for routine histopathological examination after cholecystectomy? The use of macroscopic examination. Dig Surg 2014; 30: 472-5.
Darmas B, Mahmud S, Abbas A, et al. Is there any justification for the routine histological examination of straightforward cholecystectomy specimens? Ann R Coll Surg Engl 2007; 89: 238-41.
Romero-Gonzalez RJ, Garza-Flores A, Martinez-PerezMaldonado L, et al. Gallbladder selection for histopathological analysis based on a simple method: a prospective comparative study. Ann R Coll Surg Engl 2012; 94: 159-64.
Chin KF, Mohammad AA, Khoo YY, et al. The impact of routine histopathological examination on cholecystectomy specimens from an Asian demographic. Ann R Coll Surg Engl 2012; 94: 165-9.
Lohsiriwat V, Vongjirad A, Lohsiriwat D. Value of routine histopathologic examination of three common surgical specimens: appendix, gallbladder, and hemorrhoid. World J Surg 2009; 33: 2189-93.
Samad A. Gall bladder carcinoma in patients undergoing cholecystectomy for cholelithiasis. J Pak Med Assoc 2005; 55: 497-9.
Delis S, Bakoyiannis A, Madariaga J, et al. Laparoscopic cholecystectomy in cirrhotic patients: the value of MELD score and ChildPugh classification in predicting outcome. Surg Endosc Other Interv Tech 2010; 24: 407-12.
De Zoysa MIM, De Silva SKLA, Illeperuma A. Is routine histological examination of gall bladder specimens justifiable? Ceylon Med J 2010; 55: 13-6.
Mittal R, Jesudason MR, Nayak S. Selective histopathology in cholecystectomy for gallstone disease. Indian J Gastroenterol 2010; 29: 32-6.
Byars JPD, Pursnani K. An alternative approach to sending all gallbladders for histology following cholecystectomy? Surg Sci 2012; 3: 15-20.
Elshaer M, Gravante G, Yang Y, et al. Routine versus selective histologic analysis of gallbladder specimens for the detection of incidental gallbladder cancers. A retrospective review over 9 years of activity with a special focus on patients’ age. Am J Surg 2014; 208: 444-9.
  
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