Incidental non-benign gallbladder histopathology after cholecystectomy in an United Kingdom population: Need for routine histological analysis?
OBJECTIVE
To analyse the range of histopathology detected in the largest published United Kingdom series of cholecystectomy specimens and to evaluate the rational for selective histopathological analysis.


METHODS
Incidental gallbladder malignancy is rare in the United Kingdom with recent literature supporting selective histological assessment of gallbladders after routine cholecystectomy. All cholecystectomy gallbladder specimens examined by the histopathology department at our hospital during a five year period between March 2008 and March 2013 were retrospectively analysed. Further data was collected on all specimens demonstrating carcinoma, dysplasia and polypoid growths.


RESULTS
The study included 4027 patients. The majority (97%) of specimens exhibited gallstone or cholecystitis related disease. Polyps were demonstrated in 44 (1.09%), the majority of which were cholesterol based (41/44). Dysplasia, ranging from low to multifocal high-grade was demonstrated in 55 (1.37%). Incidental primary gallbladder adenocarcinoma was detected in 6 specimens (0.15%, 5 female and 1 male), and a single gallbladder revealed carcinomain situ(0.02%). This large single centre study demonstrated a full range of gallbladder disease from cholecystectomy specimens, including more than 1% neoplastic histology and two cases of macroscopically occult gallbladder malignancies.


CONCLUSIONS
Routine histological evaluation of all elective and emergency cholecystectomies is justified in a United Kingdom population as selective analysis has potential to miss potentially curable life threatening pathology.
Krashna Patel, Khaled Dajani, Satheesh Iype, Nikolaos A Chatzizacharias, Prateush Singh, Siong S Liau, Simon Harper, Asif Jah, Raaj K Praseedom, Emmanuel L Huguet, Department of Surgery, Hepato-Pancreato-Biliary Unit, Addenbrooke's Hospital, Cambridge CB20XZ, United Kingdom.
Krashna
K
Patel
Krashna Patel, Khaled Dajani, Satheesh Iype, Nikolaos A Chatzizacharias, Prateush Singh, Siong S Liau, Simon Harper, Asif Jah, Raaj K Praseedom, Emmanuel L Huguet, Department of Surgery, Hepato-Pancreato-Biliary Unit, Addenbrooke's Hospital, Cambridge CB20XZ, United Kingdom.
Khaled
K
Dajani
Krashna Patel, Khaled Dajani, Satheesh Iype, Nikolaos A Chatzizacharias, Prateush Singh, Siong S Liau, Simon Harper, Asif Jah, Raaj K Praseedom, Emmanuel L Huguet, Department of Surgery, Hepato-Pancreato-Biliary Unit, Addenbrooke's Hospital, Cambridge CB20XZ, United Kingdom.
Satheesh
S
Iype
Krashna Patel, Khaled Dajani, Satheesh Iype, Nikolaos A Chatzizacharias, Prateush Singh, Siong S Liau, Simon Harper, Asif Jah, Raaj K Praseedom, Emmanuel L Huguet, Department of Surgery, Hepato-Pancreato-Biliary Unit, Addenbrooke's Hospital, Cambridge CB20XZ, United Kingdom.
Nikolaos A
NA
Chatzizacharias
Krashna Patel, Khaled Dajani, Satheesh Iype, Nikolaos A Chatzizacharias, Prateush Singh, Siong S Liau, Simon Harper, Asif Jah, Raaj K Praseedom, Emmanuel L Huguet, Department of Surgery, Hepato-Pancreato-Biliary Unit, Addenbrooke's Hospital, Cambridge CB20XZ, United Kingdom.
Saranya
S
Vickramarajah
Krashna Patel, Khaled Dajani, Satheesh Iype, Nikolaos A Chatzizacharias, Prateush Singh, Siong S Liau, Simon Harper, Asif Jah, Raaj K Praseedom, Emmanuel L Huguet, Department of Surgery, Hepato-Pancreato-Biliary Unit, Addenbrooke's Hospital, Cambridge CB20XZ, United Kingdom.
Prateush
P
Singh
Krashna Patel, Khaled Dajani, Satheesh Iype, Nikolaos A Chatzizacharias, Prateush Singh, Siong S Liau, Simon Harper, Asif Jah, Raaj K Praseedom, Emmanuel L Huguet, Department of Surgery, Hepato-Pancreato-Biliary Unit, Addenbrooke's Hospital, Cambridge CB20XZ, United Kingdom.
Susan
S
Davies
Krashna Patel, Khaled Dajani, Satheesh Iype, Nikolaos A Chatzizacharias, Prateush Singh, Siong S Liau, Simon Harper, Asif Jah, Raaj K Praseedom, Emmanuel L Huguet, Department of Surgery, Hepato-Pancreato-Biliary Unit, Addenbrooke's Hospital, Cambridge CB20XZ, United Kingdom.
Rebecca
R
Brais
Krashna Patel, Khaled Dajani, Satheesh Iype, Nikolaos A Chatzizacharias, Prateush Singh, Siong S Liau, Simon Harper, Asif Jah, Raaj K Praseedom, Emmanuel L Huguet, Department of Surgery, Hepato-Pancreato-Biliary Unit, Addenbrooke's Hospital, Cambridge CB20XZ, United Kingdom.
Siong S
SS
Liau
Krashna Patel, Khaled Dajani, Satheesh Iype, Nikolaos A Chatzizacharias, Prateush Singh, Siong S Liau, Simon Harper, Asif Jah, Raaj K Praseedom, Emmanuel L Huguet, Department of Surgery, Hepato-Pancreato-Biliary Unit, Addenbrooke's Hospital, Cambridge CB20XZ, United Kingdom.
Simon
S
Harper
Krashna Patel, Khaled Dajani, Satheesh Iype, Nikolaos A Chatzizacharias, Prateush Singh, Siong S Liau, Simon Harper, Asif Jah, Raaj K Praseedom, Emmanuel L Huguet, Department of Surgery, Hepato-Pancreato-Biliary Unit, Addenbrooke's Hospital, Cambridge CB20XZ, United Kingdom.
Asif
A
Jah
Krashna Patel, Khaled Dajani, Satheesh Iype, Nikolaos A Chatzizacharias, Prateush Singh, Siong S Liau, Simon Harper, Asif Jah, Raaj K Praseedom, Emmanuel L Huguet, Department of Surgery, Hepato-Pancreato-Biliary Unit, Addenbrooke's Hospital, Cambridge CB20XZ, United Kingdom.
Raaj K
RK
Praseedom
Krashna Patel, Khaled Dajani, Satheesh Iype, Nikolaos A Chatzizacharias, Prateush Singh, Siong S Liau, Simon Harper, Asif Jah, Raaj K Praseedom, Emmanuel L Huguet, Department of Surgery, Hepato-Pancreato-Biliary Unit, Addenbrooke's Hospital, Cambridge CB20XZ, United Kingdom.
Emmanuel L
EL
Huguet
Carcinoma; Cholecystectomy; Gallbladder; Histopathology; Incidental