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Surgery Research and Practice
Volume 2016, Article ID 9319147, 4 pages
http://dx.doi.org/10.1155/2016/9319147
Research Article

Surgically Resected Gall Bladder: Is Histopathology Needed for All?

1Department of Surgery, Jinnah Medical College Hospital, S. R-6, 7/A, Korangi Industrial Area, Karachi-74900, Pakistan
2Department of Family & Community Medicine, College of Medicine, King Faisal University, Saudi Arabia
3Department of Obstetrics and Gynecology, Jinnah Medical College Hospital, S. R-6, 7/A, Korangi Industrial Area, Karachi-74900, Pakistan
4Department of Emergency, Jinnah Medical College Hospital, S. R-6, 7/A, Korangi Industrial Area, Karachi-74900, Pakistan
5Mind and Brain Serviceline, Aga Khan University Hospital, P.O. Box 3500, Stadium Road, Karachi, Pakistan

Received 24 December 2015; Accepted 16 March 2016

Academic Editor: Michael Hünerbein

Copyright © 2016 Vikash Talreja et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Laparoscopic cholecystectomy is considered to be gold standard for symptomatic gall stones. As a routine every specimen is sent for histopathological examination postoperatively. Incidentally finding gall bladder cancers in those specimens is around 0.5–1.1%. The aim of this study is to identify those preoperative and intraoperative factors in patients with incidental gall bladder cancer to reduce unnecessary work load on pathologist and cost of investigation particularly in a developing world. Methods. Retrospective records were analyzed from January 2005 to February 2015 in a surgical unit. Demographic data, preoperative imaging, peroperative findings, macroscopic appearance, and histopathological findings were noted. Gall bladder wall was considered to be thickened if ≥3 mm on preoperative imaging or surgeons comment (on operative findings) and histopathology report. AJCC TNM system was used to stage gall bladder cancer. Results. 973 patients underwent cholecystectomy for symptomatic gallstone disease. Gallbladder carcinoma was incidentally found in 11 cases. Macroscopic abnormalities of the gallbladder were found in all those 11 patients. In patients with a macroscopically normal gallbladder, there were no cases of gallbladder carcinoma. Conclusion. Preoperative and operative findings play a pivotal role in determining incidental chances of gall bladder malignancy.