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Surgical Endoscopy
Published in: Surgical Endoscopy 12/2013

01-12-2013 | Review

Routine histopathology for carcinoma in cholecystectomy specimens not evidence based: a systematic review

Authors: Hilko A. Swank, Irene M. Mulder, Wim C. Hop, Marc J. van de Vijver, Johan F. Lange, Willem A. Bemelman

Published in: Surgical Endoscopy | Issue 12/2013

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Abstract

Background

Routine histopathological examination of gallbladder specimens is mainly performed to identify unexpected gallbladder carcinoma (GBC). This systematic review assesses the prevalence and characteristics of GBC in cholecystectomy specimens.

Methods

PubMed, EMBASE, Web of Science, and the Cochrane Library were searched for all articles reporting on the finding of GBC in cholecystectomy specimens.

Results

Of the 30 articles included, 20 were from Europe and the United States, and 10 were of Asian origin. In the Western studies, 276 cases of GBC were found in 61,542 specimens (median prevalence 0.4 %, 95 % confidence interval [CI] 0.3–0.6). Of these, 65 % were expected pre- or intraoperatively. In the Asian studies, 344 cases of GBC were found in 37,365 specimens (median prevalence 1.2 %, 95 % CI 0.8–1.7). Of these, 45 % were expected pre- or intraoperatively. In a subgroup analysis, identification of previously unexpected GBC affected treatment in only a minority of patients. In total, 72 % of the patients received no further treatment and 32 patients (22 %) received secondary surgery, of whom 15 patients survived at least 1 year.

Conclusions

The histopathological finding of GBC after cholecystectomy appears to be a rare event. The prevalence of unexpected GBC was higher in Asian studies than in Western studies. The pre- and intraoperative sensitivity for this carcinoma is low. Moreover, the diagnosis of GBC at the time of histopathology is usually inconsequential. The results of this systematic review do not support routine histopathology of cholecystectomy specimens in clinical practice.
Appendix
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Metadata
Title
Routine histopathology for carcinoma in cholecystectomy specimens not evidence based: a systematic review
Authors
Hilko A. Swank
Irene M. Mulder
Wim C. Hop
Marc J. van de Vijver
Johan F. Lange
Willem A. Bemelman
Publication date
01-12-2013
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 12/2013
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-013-3084-3

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