Is frozen section effective for diagnosis of unsuspected gallbladder cancer during laparoscopic cholecystectomy?
BACKGROUND
Although frozen section is recommended to prevent tumor dissemination following laparoscopic cholecystectomy (LC) for unsuspected gallbladder cancer, there are no reports concretely demonstrating its effectiveness and outcome.


METHODS
Frozen section during LC was performed in 990 patients with gallstones. The sensitivity, specificity of frozen section, and false-negative cases were evaluated in comparison with postoperative entire cross sections.


RESULTS
In frozen section, 983 cases were diagnosed as benign and 7 cases as malignant. Of the benign cases, cancer was discovered in 4 patients postoperatively in which frozen section was diagnosed as regenerative epithelial severe atypia. Sensitivity was 64% and specificity was 100%. Concerning the results of frozen section by p-TNM classification, cancer was diagnosed in 40% of Tis lesions, whereas it was found in 83% of T2 or T3 lesions.


CONCLUSIONS
Frozen section is effective in cases with T2 or greater lesions for which conversion to radical surgery should be required.
Aoki
T
T
Department of Surgery, Tokyo Medical University, 6-7-1 Nishi-Shinjuku, Shinjuku-Ku, Tokyo 160-0023, Japan. akibobo@hotmail.com
Tsuchida
A
A
Kasuya
K
K
Inoue
K
K
Saito
H
H
Koyanagi
Y
Y
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D005260:Female; D005629:Frozen Sections / Q000379:methods* / Q000592:standards; D005706:Gallbladder Neoplasms / Q000175:diagnosis* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity