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Routine Histopathology for Resected Gallbladder Specimens: Outcomes and Cost-benefit Analysis at a District General Hospital, Retrospective Cohort Study

Received: 21 June 2021     Accepted: 2 July 2021     Published: 15 July 2021
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Abstract

Routine histopathological assessment of resected gallbladder specimens is a common practice in the UK. However, the incidence of incidental gallbladder cancer is low and there is a debate over whether selective histopathology is more appropriate. Here we aim to identify the incidence of malignant and pre-malignant disease upon routine histological analysis of gallbladder specimens in Ealing hospital. We conducted a retrospective analysis of gallbladder histopathology reports was performed for all patients undergoing cholecystectomy at Ealing Hospital between June 2011 and December 2018. Demographic information, operative findings, pathology results, staging, treatment and outcome information were collected for each case of malignant or pre-malignant disease. The total financial cost of histopathological analysis of resected specimens was calculated. A total of 1,612 patients underwent cholecystectomy with histopathological assessment of the resected specimen. The majority of specimens showed chronic cholecystitis 71.3%. Acute cholecystitis 28.1%. Gall bladder polyps found in two patients 0.12%. Low grade dysplasia was identified in three patients 0.19% while high grade dysplasia was identified in two patients 0.12%, and malignant disease was reported in three patients 0.19%, two patients had stage 2 and one had stage 3 gall bladder cancer. All cases of malignant disease were identified by the surgeon intra-operatively on gross inspection. The cost of routine histopathological analysis was £128 per patient. The incidence of pre-malignant or malignant gallbladder disease after cholecystectomy is rare. A selective approach to histopathological assessment, based on patient age, clinical presentation and intra-operative findings, will provide a financial and labour cost saving.

Published in Science Research (Volume 9, Issue 4)
DOI 10.11648/j.sr.20210904.12
Page(s) 51-54
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

Gallbladder, Histopathology, Cost

References
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[6] Lundgren L, Muszynska C, Ros A, Persson G, Gimm O, Valter L, et al. Are Incidental Gallbladder Cancers Missed with a Selective Approach of Gallbladder Histology at Cholecystectomy? World J Surg. United States; 2018 Apr; 42: 1092–1099.
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[14] Ethun CG, Le N, Lopez-Aguiar AG, Pawlik TM, Poultsides G, Tran T, et al. Pathologic and Prognostic Implications of Incidental versus Nonincidental Gallbladder Cancer: A 10-Institution Study from the United States Extrahepatic Biliary Malignancy Consortium. Am Surg. United States; 2017 Jul; 83: 679–686.
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Cite This Article
  • APA Style

    Aboutaleb Esam, Saleh Fatima, Pore Naresh, Raje Durgesh, Mitsopoulos Grigos, et al. (2021). Routine Histopathology for Resected Gallbladder Specimens: Outcomes and Cost-benefit Analysis at a District General Hospital, Retrospective Cohort Study. Science Research, 9(4), 51-54. https://doi.org/10.11648/j.sr.20210904.12

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    ACS Style

    Aboutaleb Esam; Saleh Fatima; Pore Naresh; Raje Durgesh; Mitsopoulos Grigos, et al. Routine Histopathology for Resected Gallbladder Specimens: Outcomes and Cost-benefit Analysis at a District General Hospital, Retrospective Cohort Study. Sci. Res. 2021, 9(4), 51-54. doi: 10.11648/j.sr.20210904.12

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    AMA Style

    Aboutaleb Esam, Saleh Fatima, Pore Naresh, Raje Durgesh, Mitsopoulos Grigos, et al. Routine Histopathology for Resected Gallbladder Specimens: Outcomes and Cost-benefit Analysis at a District General Hospital, Retrospective Cohort Study. Sci Res. 2021;9(4):51-54. doi: 10.11648/j.sr.20210904.12

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  • @article{10.11648/j.sr.20210904.12,
      author = {Aboutaleb Esam and Saleh Fatima and Pore Naresh and Raje Durgesh and Mitsopoulos Grigos and Sheth Hemant},
      title = {Routine Histopathology for Resected Gallbladder Specimens: Outcomes and Cost-benefit Analysis at a District General Hospital, Retrospective Cohort Study},
      journal = {Science Research},
      volume = {9},
      number = {4},
      pages = {51-54},
      doi = {10.11648/j.sr.20210904.12},
      url = {https://doi.org/10.11648/j.sr.20210904.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.sr.20210904.12},
      abstract = {Routine histopathological assessment of resected gallbladder specimens is a common practice in the UK. However, the incidence of incidental gallbladder cancer is low and there is a debate over whether selective histopathology is more appropriate. Here we aim to identify the incidence of malignant and pre-malignant disease upon routine histological analysis of gallbladder specimens in Ealing hospital. We conducted a retrospective analysis of gallbladder histopathology reports was performed for all patients undergoing cholecystectomy at Ealing Hospital between June 2011 and December 2018. Demographic information, operative findings, pathology results, staging, treatment and outcome information were collected for each case of malignant or pre-malignant disease. The total financial cost of histopathological analysis of resected specimens was calculated. A total of 1,612 patients underwent cholecystectomy with histopathological assessment of the resected specimen. The majority of specimens showed chronic cholecystitis 71.3%. Acute cholecystitis 28.1%. Gall bladder polyps found in two patients 0.12%. Low grade dysplasia was identified in three patients 0.19% while high grade dysplasia was identified in two patients 0.12%, and malignant disease was reported in three patients 0.19%, two patients had stage 2 and one had stage 3 gall bladder cancer. All cases of malignant disease were identified by the surgeon intra-operatively on gross inspection. The cost of routine histopathological analysis was £128 per patient. The incidence of pre-malignant or malignant gallbladder disease after cholecystectomy is rare. A selective approach to histopathological assessment, based on patient age, clinical presentation and intra-operative findings, will provide a financial and labour cost saving.},
     year = {2021}
    }
    

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    AB  - Routine histopathological assessment of resected gallbladder specimens is a common practice in the UK. However, the incidence of incidental gallbladder cancer is low and there is a debate over whether selective histopathology is more appropriate. Here we aim to identify the incidence of malignant and pre-malignant disease upon routine histological analysis of gallbladder specimens in Ealing hospital. We conducted a retrospective analysis of gallbladder histopathology reports was performed for all patients undergoing cholecystectomy at Ealing Hospital between June 2011 and December 2018. Demographic information, operative findings, pathology results, staging, treatment and outcome information were collected for each case of malignant or pre-malignant disease. The total financial cost of histopathological analysis of resected specimens was calculated. A total of 1,612 patients underwent cholecystectomy with histopathological assessment of the resected specimen. The majority of specimens showed chronic cholecystitis 71.3%. Acute cholecystitis 28.1%. Gall bladder polyps found in two patients 0.12%. Low grade dysplasia was identified in three patients 0.19% while high grade dysplasia was identified in two patients 0.12%, and malignant disease was reported in three patients 0.19%, two patients had stage 2 and one had stage 3 gall bladder cancer. All cases of malignant disease were identified by the surgeon intra-operatively on gross inspection. The cost of routine histopathological analysis was £128 per patient. The incidence of pre-malignant or malignant gallbladder disease after cholecystectomy is rare. A selective approach to histopathological assessment, based on patient age, clinical presentation and intra-operative findings, will provide a financial and labour cost saving.
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Author Information
  • General Surgery Department, Ealing Hospital, London North West Trust, London, UK

  • General Surgery Department, Ealing Hospital, London North West Trust, London, UK

  • General Surgery Department, Ealing Hospital, London North West Trust, London, UK

  • General Surgery Department, Ealing Hospital, London North West Trust, London, UK

  • General Surgery Department, Ealing Hospital, London North West Trust, London, UK

  • General Surgery Department, Ealing Hospital, London North West Trust, London, UK

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