{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T01:11:26Z","timestamp":1793409086607,"version":"4.5.0"},"reference-count":97,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2021,2,17]],"date-time":"2021-02-17T00:00:00Z","timestamp":1613520000000},"content-version":"vor","delay-in-days":224,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,9,16]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Routine histopathological examination after cholecystectomy is costly, but the prevalence of unsuspected gallbladder cancer (incidental GBC) is low. This study determined whether selective histopathological examination is safe.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A comprehensive search of PubMed, Embase, Web of Science and the Cochrane Library was performed. Pooled incidences of incidental and truly incidental GBC (GBC detected during histopathological examination without preoperative or intraoperative suspicion) were estimated using a random-effects model. The clinical consequences of truly incidental GBC were assessed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Seventy-three studies (232 155 patients) were included. In low-incidence countries, the pooled incidence was 0\u00b732 (95 per cent c.i. 0\u00b725 to 0\u00b742) per cent for incidental GBC and 0\u00b718 (0\u00b710 to 0\u00b735) per cent for truly incidental GBC. Subgroup analysis of studies in which surgeons systematically examined the gallbladder revealed a pooled incidence of 0\u00b704 (0\u00b701 to 0\u00b714) per cent. In high-incidence countries, corresponding pooled incidences were 0\u00b783 (0\u00b758 to 1\u00b718), 0\u00b744 (0\u00b721 to 0\u00b791) and 0\u00b708 (0\u00b702 to 0\u00b739) per cent respectively. Clinical consequences were reported for 176 (39\u00b73 per cent) of 448 patients with truly incidental GBC. Thirty-three patients (18\u00b78 per cent) underwent secondary surgery. Subgroup analysis showed that at least half of GBC not detected during the surgeon's systematic examination of the gallbladder was early stage (T1a status or below) and of no clinical consequence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Selective histopathological examination of the gallbladder after initial macroscopic assessment by the surgeon seems safe and could reduce costs.<\/jats:p><\/jats:sec>","DOI":"10.1002\/bjs.11759","type":"journal-article","created":{"date-parts":[[2020,7,8]],"date-time":"2020-07-08T12:25:06Z","timestamp":1594211106000},"page":"1414-1428","source":"Crossref","is-referenced-by-count":22,"title":["Safe, selective histopathological examination of gallbladder specimens: a systematic review"],"prefix":"10.1093","volume":"107","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8711-9383","authenticated-orcid":false,"given":"V P","family":"Bastiaenen","sequence":"first","affiliation":[{"name":"Department of Surgery, Cancer Centre Amsterdam, Amsterdam UMC , Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J E","family":"Tuijp","sequence":"additional","affiliation":[{"name":"Department of Surgery, Cancer Centre Amsterdam, Amsterdam UMC , Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Dieren","sequence":"additional","affiliation":[{"name":"Department of Surgery, Cancer Centre Amsterdam, Amsterdam UMC , Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M G","family":"Besselink","sequence":"additional","affiliation":[{"name":"Department of Surgery, Cancer Centre Amsterdam, Amsterdam UMC , Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T M","family":"Gulik","sequence":"additional","affiliation":[{"name":"Department of Surgery, Cancer Centre Amsterdam, Amsterdam UMC , Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L","family":"Koens","sequence":"additional","affiliation":[{"name":"Department of Pathology, Amsterdam UMC, University of Amsterdam , Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P J","family":"Tanis","sequence":"additional","affiliation":[{"name":"Department of Surgery, Cancer Centre Amsterdam, Amsterdam UMC , Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W A","family":"Bemelman","sequence":"additional","affiliation":[{"name":"Department of Surgery, Cancer Centre Amsterdam, Amsterdam UMC , Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,7,8]]},"reference":[{"key":"2022100812584605800_bjs11759-bib-0001","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1046\/j.1365-2168.1998.00566.x","article-title":"\u2018Routine\u2019 pathological examination of the gallbladder is a futile exercise","volume":"85","author":"Taylor","year":"1998","journal-title":"Br J Surg"},{"key":"2022100812584605800_bjs11759-bib-0002","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1016\/S1479-666X(03)80023-9","article-title":"A selective approach to histopathology of the gallbladder is justifiable","volume":"1","author":"Dix","year":"2003","journal-title":"Surgeon"},{"key":"2022100812584605800_bjs11759-bib-0003","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1308\/003588407X168361","article-title":"Is there any justification for the routine histological examination of straightforward cholecystectomy specimens?","volume":"89","author":"Darmas","year":"2007","journal-title":"Ann R Coll Surg Engl"},{"key":"2022100812584605800_bjs11759-bib-0004","doi-asserted-by":"crossref","first-page":"738","DOI":"10.1308\/003588407X209473","article-title":"Routine histology of cholecystectomy specimens is unnecessary","volume":"89","author":"Oommen","year":"2007","journal-title":"Ann R Coll Surg Engl"},{"key":"2022100812584605800_bjs11759-bib-0005","doi-asserted-by":"crossref","first-page":"564","DOI":"10.1007\/s00534-007-1225-6","article-title":"Do we need histology for a normal-looking gallbladder?","volume":"14","author":"Bazoua","year":"2007","journal-title":"J Hepatobiliary Pancreat Surg"},{"key":"2022100812584605800_bjs11759-bib-0006","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1159\/000357259","article-title":"Is it necessary to send gallbladder specimens for routine histopathological examination after cholecystectomy? 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