Abstract
Objectives
To determine whether selective histopathological examination of stone disease related cholecystectomy specimens based on preoperative ultrasound and intraoperative findings is safe/sufficient or not.
Materials and Methods
A retrospective analysis of all cholecystectomies performed at King Hussien Medical Center from January 2008 to February 2010 was conducted using computerized histopathological records. The features in cases of malignancy in respect of preoperative ultrasound and intraoperative findings and gross examination were analysed.
Results
Out of 1984 (73% female and 27% male) patients undergoing cholecystectomy for gallbladder stone disease, chronic cholecystitis was the most common finding comprising 1551 cases (78%), while the second most common condition was acute or acute on top of chronic cholecystitis comprising 304 cases (15%). Malignancy was found in only 11cases (0.55%, 6 female, 5 male). All were adenocarcinoma. For carcinoma in situ (Tis), which was not suspected by preoperative ultrasound or intraoperative findings, cholecystectomy was the definite and the only treatment required for the patient. However, for the remaining cases, cancer was suspected either by intraoperative findings(9/10) and/or preoperative ultrasound (7/10).
Conclusion
Selective approach for histopathological examination of the gallbladder based upon preoperative ultrasound or intraoperative findings and macroscopic examination of the gallbladder by the surgeon or the histopthologist is reasonably safe. Such approach decreases the costs and the work load of the histopathologists. The required treatment for early gallbladder cancer (Tis, T1) which may not be suspected intra or pre operatively is only cholecystectomy. (Rawal Med J 2011;36:93-96).

Key words: Cholelithiasis, cholecystitis, adenocarcinoma gall bladder.