Department of Pathology, College of Medicine, Dawadmi, Shaqra University, Saudi Arabia.
Department of Pharmacology, College of Medicine, Dawadmi, Shaqra University, Saudi Arabia.
Asian Pac J Cancer Prev. 2021 Mar 1;22(3):651-659. doi: 10.31557/APJCP.2021.22.3.651.
Selective or Routine histology of cholecystectomy specimens for benign gallbladder disease has always been a matter of debate because of the low prevalence and bad prognosis associated with gall bladder carcinoma. The objective of this study is to ascertain whether selective histology can be preferred over Routine histology without any harm.
This systematic review is conducted according to PRISMA's checklist; relevant articles were searched in the database until September 1 2020 in PubMed, Scopus, Science Direct, and Web of Science databases, manually, with search queries and without date restrictions. Studies included in this systematic review involved patients who underwent cholecystectomy for benign gallbladder disease and were diagnosed with gallbladder carcinoma incidentally either after selective or routine histology of the gallbladder.
A total of 24 routine or selective histology recommending studies were selected for the systematic review after following the inclusion and exclusion criteria. These studies comprised 77,213 numbers of patients and 486 numbers of Malignancies. These studies correlate the number of IGBC diagnosed histologically with the number of IGBC's that were suspected by the surgeons intraoperative by macroscopy. Routine recommending studies show a significant number of IGBC diagnosed histologically as missed by surgeons whereas the selective recommending studies show most of the histologically diagnosed IGBC already suspected by the surgeons intraoperative. When comparing the macroscopic details of the IGBC's between routine and selective studies, we found that there was significant overlap. Most of the findings missed by the surgeons as suspicious in routine studies were suspected by the surgeons involved in selective histology recommending studies. Thereby, favouring selective histology and emphasizing the need for careful intraoperative macroscopy for suspecting IGBC.
Selective Histological examination of cholecystectomy specimens can be preferred if a careful intraoperative macroscopic examination is done and patient risk factors are taken into consideration.
对于良性胆囊疾病，胆囊切除术标本的选择性或常规组织学检查一直存在争议，因为与胆囊癌相关的发病率低且预后差。本研究的目的是确定选择性组织学检查是否可以在没有任何危害的情况下优先于常规组织学检查。
本系统评价根据 PRISMA 清单进行；在 PubMed、Scopus、Science Direct 和 Web of Science 数据库中，使用搜索查询并没有日期限制，对截至 2020 年 9 月 1 日的相关文章进行了检索，同时进行了手动检索。本系统评价纳入的研究包括因良性胆囊疾病接受胆囊切除术并意外通过选择性或常规胆囊组织学诊断为胆囊癌的患者。
在遵循纳入和排除标准后，共选择了 24 项常规或选择性组织学推荐研究进行系统评价。这些研究包括 77213 名患者和 486 例恶性肿瘤。这些研究将术中肉眼观察到的 IGBC 数量与外科医生术中怀疑的 IGBC 数量与组织学诊断的 IGBC 数量相关联。常规推荐研究显示，有大量的 IGBC 在组织学上被外科医生诊断为漏诊，而选择性推荐研究显示，大多数在组织学上诊断为 IGBC 的病例已经被外科医生术中怀疑。当比较常规和选择性研究中 IGBC 的宏观细节时，我们发现存在显著的重叠。在常规研究中被外科医生视为可疑的大多数发现，在选择性组织学推荐研究中也被外科医生怀疑。因此，支持选择性组织学检查，并强调需要仔细进行术中肉眼检查以怀疑 IGBC。
如果进行仔细的术中宏观检查并考虑患者的风险因素，可以优先选择胆囊切除术标本的选择性组织学检查。
