Is routine histopathological gallbladder examination necessary after cholecystectomy? Evaluation of the results of 1366 cholecystectomy specimens in single center

Abstract

Objective: It was aimed to evaluate the results of routine histopathological examination after cholecystectomy and to investigate the necessity of routine histopathologic examination after cholecystectomy. Methods: The study was designed retrospectively. One thousand three hundred sixty six patients who underwent laparoscopic and open cholecystectomy at Private Sani Konukoglu Hospital with pre-diagnosis of benign gallbladder disease between November 2011 and May 2017 were included in the study. Patients' demographic data, pathologic results, macroscopic appearance of the specimen, and cancer staging were recorded. The distribution and frequency of pathologic diagnoses and the prevalence of incidental gallbladder cancer (GBC) were evaluated. Pathologic findings were compared in terms of age groups and gender relations. Results: The number of patients included in the study was 1366. Diagnosed with chronic cholecystitis patients were 1,303 (95%), 39 (3%) with acute cholecystitis, 7 (0.5%) with gallbladder cancer, and 17 (1.5%) with other diagnoses of the patients. Statistical significance was found between the groups in terms of the mean age (p = 0.0002). Comparisons between groups in terms of cholesterolysis were statistically significant (p = 0.0003). There was a significant relationship between mucosa atrophy and gender (p = 0.001). Conclusions: The histopathological spectrum of gallbladder is quite extensive. Incidental GBC may not be detected by preoperative imaging methods. Incidental GBC are usually asymptomatic. T2, T3 and T4 GBC were also encountered in our study. All of these patients need additional operations. In the absence of routine histopathologic examination, metastatic advanced GBC may be encountered because no treatment plans could make. Thus, we do recommend routine histopathological examination.