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CC BY-NC-ND 4.0 · South Asian J Cancer 2024; 13(03): 177-184
DOI: 10.1055/s-0043-1764151
Original Article
Gastrointestinal Cancer

Practices in the Management of Incidental Gallbladder Cancer

Peeyush Varshney
1   Department of Surgical Gastroenterology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
,
Anand Nagar
2   Department of Hepato-Pancreato-Biliary Surgery, Mahatma Gandhi Medical College and Hospitals, Jaipur, Rajasthan, India
,
Shashwat Sarin
2   Department of Hepato-Pancreato-Biliary Surgery, Mahatma Gandhi Medical College and Hospitals, Jaipur, Rajasthan, India
,
Krishnavardhan Venkatatelikicherla
3   Department of Surgical Gastroenterology, Mahatma Gandhi Medical College and Hospitals, Jaipur, Rajasthan, India
,
Maunil Tomar
3   Department of Surgical Gastroenterology, Mahatma Gandhi Medical College and Hospitals, Jaipur, Rajasthan, India
,
R.P Choubey
3   Department of Surgical Gastroenterology, Mahatma Gandhi Medical College and Hospitals, Jaipur, Rajasthan, India
,
Ajay Sharma
3   Department of Surgical Gastroenterology, Mahatma Gandhi Medical College and Hospitals, Jaipur, Rajasthan, India
,
V.K Kapoor
2   Department of Hepato-Pancreato-Biliary Surgery, Mahatma Gandhi Medical College and Hospitals, Jaipur, Rajasthan, India
› Author Affiliations Financial Disclosures None.
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Abstract

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Peeyush Varshney

Background Histopathology of gallbladder removed for stones may reveal incidental gallbladder cancer (iGBC). We conducted this online e-survey to document the knowledge and practices of management of iGBC among surgeons in India.

Methods A 38-question online e-survey

Results Two-hundred thirty responses were recorded. Ninety-eight out of two-hundred (49%) responses were general surgeons. Two-hundred ten out of two-hundred twenty-one (95%) saw at least one iGBC per year, but only 74/225 (32%) correctly defined true iGBC. One-hundred seventy-eight out of two hundred twenty-two (80%) did computed tomography/magnetic resonance imaging for thick-walled gallbladder (GB) detected on ultrasound, while 25/222 (11%) did laparoscopic cholecystectomy and 14/222 (6%) did open cholecystectomy. For GB mass on laparoscopy, 16/222 (7%) responses went ahead with simple cholecystectomy. Seventy-four out of two-hundred twenty-five (32%) responses routinely used bag while extracting GB. One-hundred ninety-one out of two-hundred twenty-five (86%) mentioned about stone/bile spill, 121/220 (55%) mentioned about use of bag for extraction while 137/220 62% mentioned port used for extraction of GB in operation notes. One-hundred sixty-six out of two-hundred twenty-seven (73%) always cut open GB after cholecystectomy. On encountering a mass/lesion on cut open GB, 111/225 (49%) sent it for frozen section, 89/225 (40%) sent for routine histopathology while 10% (22/225) directly proceeded for extended cholecystectomy. Ten out of two-hundred twenty-seven (4.4%) did not consider it important to send GB for histopathology. T stage on histopathology is most important factor for deciding reoperation by 205/223 (91%).

Conclusion There are lacunae in understanding and deficiencies in management of iGBC in India—a high GBC incidence country. The situation is likely to be worse in low GBC incidence areas. There is need for more awareness and knowledge for proper management of iGBC among surgeons.

Keywords

gallbladder cancer - laparoscopic cholecystectomy - gallstones - gallstone disease - histopathology

Authors' Contributions

All the authors have seen and approved the manuscript as well as the order of authors in the manuscript. PV and VKK have contributed in conception and design of study; AS, AN, PV, MT, and KV have contributed in acquisition of data; PV, SS, and VKK have contributed in analysis and interpretation of data; PV, RPC, and VKK have contributed in drafting the manuscript; PV, RPC, and VKK have contributed in revising the manuscript critically for important intellectual content.


Supplementary Material



Publication History

Article published online:
10 August 2023

© 2023. MedIntel Services Pvt Ltd. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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