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DOI: 10.1055/s-0043-1764151
Practices in the Management of Incidental Gallbladder Cancer
Financial Disclosures None.
Abstract
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 - histopathologyAuthors' 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.
Publikationsverlauf
Artikel online veröffentlicht:
10. August 2023
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