We have found this letter of interest and especially value the authors' point on the examination of removed gall bladders by the surgeon. This practice provides a preliminary sieve to select which of the gall bladders should be further tested by the pathologist with a reasonable prospect of contributing to the clinical management of the patient. Both the futility of routine histological examination as well as the cure achieved by simple cholecystectomy in early gall bladder cancer was already mentioned in the literature.1,2
The principle of selective histological examination is neither new nor limited to the gall bladder. A similar approach is already applied in the examination of rectal ‘doughnuts’ produced after use of a circular stapler following the resection of a rectal tumour. The decision to examine these ‘doughnuts’, based on the presence or absence of margin involvement in the main specimen, is left to the pathologist.3
A wider practice of selective histopathological examination will most likely result in more effective use of resources without compromising patient safety.
We would like, as well, to congratulate the authors for their work which supports our approach to selective gall bladder histology.
References
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