Abstract
Background Incidental gallbladder cancer is relatively rare, with an incidence ranging between
0.19 and 5.5% of all the cholecystectomies for benign disease, and carries a poor
prognosis. Currently, in the literature, there appears to be some controversy about
whether all gallbladder specimens should be sent for routine histopathology. The aim
of this study was to investigate the need for either routine or selective histopathological
evaluation of all gallbladder specimens following cholecystectomy in our institution.
Methods The records of all patients who underwent a cholecystectomy (laparoscopic and open)
for gallstone disease over a 5-year period (between January 2011 and January 2016)
were reviewed retrospectively in a single university teaching hospital. Patients with
radiological evidence of gallbladder cancer preoperatively were excluded. The notes
of patients with incidental gallbladder cancer were reviewed and data were collected
for clinical presentation and preoperative investigations including blood tests and
radiological imaging.
Results A total of 1,473 specimens were sent for histopathological evaluation, with two patients
being diagnosed with an incidental gallbladder cancer (papillary adenocarcinoma in
situ and moderately differentiated invasive adenocarcinoma [stage IIIa]). The incidence
rate was 0.14%. All patients with incidental gallbladder cancer had macroscopically
abnormal specimens.
Conclusion Both patients in our study who were diagnosed with incidental gallbladder cancer
had macroscopic abnormalities. A selective rather than routine approach to histological
evaluation of gallbladder specimens especially in those with macroscopic abnormalities
should be employed. This will reduce the burden on the pathology department with potential
cost savings.
Keywords
cholecystectomy - histology - incidental gallbladder cancer
