Should every cholecystectomy specimen be sent for histopathology to identify incidental gall bladder cancer ?
Ganesh Nagarajan, Kaushal KundaliaIndian Journal of Cancer 2020 57(1):2-3
In conclusion, survival advantages are shown for patients with T1b gallbladder cancer undergoing surgeries with lymphadenectomy. Future studies with longer follow‐u p and control of potential confounders are highly warranted.
Conclusion: All cholecystectomy specimens must be examined by histopathologists who must decide whether processing for microscopy is needed. Microscopic examination may be reserved for the specimen with a macroscopic lesion. This will result in a reduction of costs and pathology workload without compromising patient management.
ConclusionsA policy of selective histopathology after cholecystectomy is oncologically safe and reduces costs.
DISCUSSION: US survey underestimated the incidence of PLG compared to the histological finding (p=0.021). Female gender has been shown to be a specific risk factor for benign and malignant PLG and non-polypoid mucosal lesions (p=0.041). The parietal lesion size
ConclusionsIn carefully selected patients of GB NECs, downsizing with NACT facilitates radical resection with negative margins.
ConclusionHPB surgeons should adopt an aggressive policy to treat patients who have undergone previous major abdominal surgery.
AbstractExcision of port site (PSE) for patients having undergone laparoscopic cholecystectomy (LC) is not a standard recommendation. We retrospectively evaluated a cohort of patients with isolated PSM without any prior cancer-directed therapy who were assessed for resection between March 2012 and July 2016 at Tata Memorial Hospital, Mumbai. Eleven of a total 13 patients underwent wide excision for PSM in the given time period. Upfront resection was undertaken in six patients while seven patients received neoadjuvant chemotherapy (NACT) and two received neoadjuvant chemo radiotherapy (NACTRT) prior to attempted resection. ...
We describe two cases of metastatic GBC initially treated by simple cholecystectomy for gallstone despite disease pointers towards a malignant pathology. Subsequent presentation was with histopathologically proven metastatic GBC. In an area of high gallsone prevalence, a high index of suspicion and correct management of patients with suspicion of GBC is mandatory. PMID: 30089420 [PubMed - as supplied by publisher]
CONCLUSION: Gallbladder tumours detected incidentally could extend survival rates with proper surgical intervention and chemotherapy. The possibility of a tumour should not be dismissed in those patients with advanced age, females or patients with gallbladder stones. Frozen specimens should be created during a cholecystectomy, and if there is any doubt about the diagnosis, a postoperative histopathological examination of the gallbladder should be conducted. KEY WORDS: Cholecystectomy, Gall bladder stone, Incidental gallbladder carcinoma. PMID: 29197189 [PubMed - in process]
ConclusionSurgery alone is curative only for early GBC (Stage I). Combination of surgery and peri‐operative systemic therapy results in favorable outcomes even in stage II/III disease. Potentially, multimodality treatment may add meaningful survival for this disease with inherently aggressive tumor biology.