We agree with the conclusions of the authors that routine histology of cholecystectomy specimens is unnecessary. A retrospective audit, similar to the one in the article, of histological findings of all gallbladders removed at our hospital between January 2000 and September 2004 found only one cancer of the gall bladder out of 976 specimens and this was suspected at operation.
We believe that the outcome of final histology does not alter management and currently adopt a selective approach to sending specimens. All excised gallbladders are examined in theatre by the operating surgeon and only those with suspicious lesions (such as polyps, nodules, ulcers, indurated wall or penetration into the liver bed) are sent for histological examination.1 It can also be argued that early gall bladder cancer (pT1) missed on macroscopic examination needs no further surgery apart from cholecystectomy.2
Footnotes
References
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