title: Routine versus selective histologic analysis of gallbladder specimens for the detection of incidental gallbladder cancers. A retrospective review over 9 years of activity with a special focus on patients' age.
abstract: BACKGROUND
  Incidental gallbladder cancer (IGC) is an infrequent possibility in patients undergoing cholecystectomies. Routine histologic examination of all gallbladder specimens is the current approach to detect this disease. Our study presents the influence of age to perform a selective histologic analysis.
  
  
  METHODS
  A retrospective review was conducted of all gallbladder specimens during the last 9 years in our hospital. The medical notes were retrieved for cases of IGC or dysplasia and perioperative data were collected.
  
  
  RESULTS
  A total of 3,330 cholecystectomies were conducted over the study period, 3,041 for gallstone disease. Twelve patients were found with dysplasia and 13 patients with IGC, all of them occurred in gallbladders removed for gallstone diseases. There were 18 men with a median age of 65 years (range 18 to 85). Median age for cancer patients was 70 years (range 51 to 85) and 54 years for dysplasia (range 18 to 75). No patient below the age of 51 years (n = 1,464) experienced IGCs.
  
  
  CONCLUSIONS
  Age should be considered as an additional factor for a selective approach to the histologic analysis of all gallbladder specimens following cholecystectomies.
authors.affiliation: Department of Surgery, Kettering General Hospital, Rothwell Road, Kettering NN16 8UZ, UK.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Elshaer
authors.affiliation: Department of Surgery, Kettering General Hospital, Rothwell Road, Kettering NN16 8UZ, UK. Electronic address: ggravante@hotmail.com.
authors.forename: Gianpiero
authors.initials: G
authors.lastname: Gravante
authors.affiliation: Department of Surgery, Kettering General Hospital, Rothwell Road, Kettering NN16 8UZ, UK.
authors.forename: Yifan
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Department of Surgery, Kettering General Hospital, Rothwell Road, Kettering NN16 8UZ, UK.
authors.forename: Sarah
authors.initials: S
authors.lastname: Hudson
authors.affiliation: Department of Surgery, Kettering General Hospital, Rothwell Road, Kettering NN16 8UZ, UK.
authors.forename: Katie
authors.initials: K
authors.lastname: Thomas
authors.affiliation: Department of Human Physiology, Laboratory of Biometry, University of Tor Vergata, Rome, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Sorge
authors.affiliation: Department of Surgery, Kettering General Hospital, Rothwell Road, Kettering NN16 8UZ, UK.
authors.forename: Salem
authors.initials: S
authors.lastname: Al-Hamali
authors.affiliation: Department of Surgery, Kettering General Hospital, Rothwell Road, Kettering NN16 8UZ, UK.
authors.forename: Ashish
authors.initials: A
authors.lastname: Kelkar
authors.affiliation: Department of Surgery, Kettering General Hospital, Rothwell Road, Kettering NN16 8UZ, UK.
authors.forename: Hamdi
authors.initials: H
authors.lastname: Ebdewi
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002763:Cholecystectomy; D003661:Decision Support Techniques; D005260:Female; D005704:Gallbladder / Q000473:pathology* / Q000601:surgery; D005706:Gallbladder Neoplasms / Q000209:etiology / Q000473:pathology*; D006801:Humans; D033162:Incidental Findings; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
keywords: Cholecystectomies; Gallbladder cancer; Histology