Safe, selective histopathological examination of gallbladder specimens: a systematic review
Background 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. Methods A comprehensive search of PubMed, Embase, Web of Scie...
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| Veröffentlicht in: | British journal of surgery 2020-10, Vol.107 (11), p.1414-1428 |
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| creator | Bastiaenen, V. P. Tuijp, J. E. Dieren, S. Besselink, M. G. Gulik, T. M. Koens, L. Tanis, P. J. Bemelman, W. A. |
| description | Background
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.
Methods
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.
Results
Seventy‐three studies (232 155 patients) were included. In low‐incidence countries, the pooled incidence was 0·32 (95 per cent c.i. 0·25 to 0·42) per cent for incidental GBC and 0·18 (0·10 to 0·35) per cent for truly incidental GBC. Subgroup analysis of studies in which surgeons systematically examined the gallbladder revealed a pooled incidence of 0·04 (0·01 to 0·14) per cent. In high‐incidence countries, corresponding pooled incidences were 0·83 (0·58 to 1·18), 0·44 (0·21 to 0·91) and 0·08 (0·02 to 0·39) per cent respectively. Clinical consequences were reported for 176 (39·3 per cent) of 448 patients with truly incidental GBC. Thirty‐three patients (18·8 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.
Conclusion
Selective histopathological examination of the gallbladder after initial macroscopic assessment by the surgeon seems safe and could reduce costs.
Antecedentes
El examen histopatológico rutinario después de la colecistectomía es caro y la prevalencia de cáncer de vesícula biliar (gallbladder cancer, GBC) no sospechado o incidental es baja. Este estudio determinó si el examen histológico selectivo es seguro.
Métodos
Se realizó una búsqueda exhaustiva en PubMed, Embase, Web of Science y en la Biblioteca Cochrane. Se estimaron las incidencias agrupadas de GBC incidental y realmente incidental (GBC detectado durante el examen histopatológico sin sospecha previa o intraoperatoria) utilizando un modelo de efectos aleatorios. Además, se evaluaron las consecuencias clínicas del GBC realmente incidental.
Resultados
Se incluyeron 73 estudios (n = 232.155). En los países de baja incidencia, la incidencia agrupada fue de 0,32% para el GBC incidental (i.c. del 95% 0, |
| doi_str_mv | 10.1002/bjs.11759 |
| format | Article |
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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.
Methods
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.
Results
Seventy‐three studies (232 155 patients) were included. In low‐incidence countries, the pooled incidence was 0·32 (95 per cent c.i. 0·25 to 0·42) per cent for incidental GBC and 0·18 (0·10 to 0·35) per cent for truly incidental GBC. Subgroup analysis of studies in which surgeons systematically examined the gallbladder revealed a pooled incidence of 0·04 (0·01 to 0·14) per cent. In high‐incidence countries, corresponding pooled incidences were 0·83 (0·58 to 1·18), 0·44 (0·21 to 0·91) and 0·08 (0·02 to 0·39) per cent respectively. Clinical consequences were reported for 176 (39·3 per cent) of 448 patients with truly incidental GBC. Thirty‐three patients (18·8 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.
Conclusion
Selective histopathological examination of the gallbladder after initial macroscopic assessment by the surgeon seems safe and could reduce costs.
Antecedentes
El examen histopatológico rutinario después de la colecistectomía es caro y la prevalencia de cáncer de vesícula biliar (gallbladder cancer, GBC) no sospechado o incidental es baja. Este estudio determinó si el examen histológico selectivo es seguro.
Métodos
Se realizó una búsqueda exhaustiva en PubMed, Embase, Web of Science y en la Biblioteca Cochrane. Se estimaron las incidencias agrupadas de GBC incidental y realmente incidental (GBC detectado durante el examen histopatológico sin sospecha previa o intraoperatoria) utilizando un modelo de efectos aleatorios. Además, se evaluaron las consecuencias clínicas del GBC realmente incidental.
Resultados
Se incluyeron 73 estudios (n = 232.155). En los países de baja incidencia, la incidencia agrupada fue de 0,32% para el GBC incidental (i.c. del 95% 0,25 a 0,42) y de 0,18% (0,10 a 0,35) para GBC realmente incidental. El análisis de subgrupos que incluye estudios en los que los cirujanos examinaron sistemáticamente la vesícula biliar reveló una incidencia agrupada de 0,04% (0,01 a 0,14). En los países de alta incidencia, las incidencias agrupadas correspondientes fueron 0,83% (0,58 a 1,18), 0,44% (0.2 a 0.91) y 0,08% (0,02 a 0,39), respectivamente. Se describieron consecuencias clínicas en 176 (39,3%) de 448 pacientes con GBC realmente incidental. Treinta y tres pacientes (18,6%) se sometieron a cirugía secundaria. El análisis por subgrupos mostró que al menos la mitad de los GBC no detectados durante el examen sistemático de la vesícula biliar por parte del cirujano eran tumores de estadio precoz (≤ T1a) y sin consecuencias clínicas.
Conclusión
El examen histológico selectivo de vesículas biliares después de la evaluación macroscópica inicial realizada por el cirujano parece seguro y podría reducir los costes.
This meta‐analysis found that the incidence of truly incidental gallbladder cancer (GBC) was less than 0·5 per cent and decreased to less than 0·1 per cent when the surgeon performed a systematic macroscopic examination. At least 50 per cent of GBC that was not detected before or during surgery was of early stage and with no clinical consequences. Particularly in non‐endemic regions, selective histopathological examination after initital macroscopic assessment of the gallbladder by the surgeon seems safe and will likely result in significant cost and time savings.
Open and palpate it</description><identifier>ISSN: 0007-1323</identifier><identifier>EISSN: 1365-2168</identifier><identifier>DOI: 10.1002/bjs.11759</identifier><identifier>PMID: 32639049</identifier><language>eng</language><publisher>Chichester, UK: John Wiley & Sons, Ltd</publisher><subject>Cholecystectomy ; Gallbladder ; Gallbladder - pathology ; Gallbladder - surgery ; Gallbladder cancer ; Gallbladder Neoplasms - epidemiology ; Gallbladder Neoplasms - pathology ; Gallbladder Neoplasms - surgery ; Global Health ; Histopathology ; HPB ; Humans ; Incidence ; Incidental Findings ; Models, Statistical ; Neoplasm Staging ; Patient Safety ; Patient Selection ; Surgeons ; Systematic Review</subject><ispartof>British journal of surgery, 2020-10, Vol.107 (11), p.1414-1428</ispartof><rights>2020 The Authors. published by John Wiley & Sons Ltd on behalf of BJS Society Ltd.</rights><rights>2020 The Authors. British Journal of Surgery published by John Wiley & Sons Ltd on behalf of BJS Society Ltd.</rights><rights>2020. This article is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4099-b393f7cf2b126d8533c6618792445c2adec0bfeeb6e867a189527aa46afde0f93</citedby><orcidid>0000-0002-8711-9383</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fbjs.11759$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fbjs.11759$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>230,314,780,784,885,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32639049$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bastiaenen, V. P.</creatorcontrib><creatorcontrib>Tuijp, J. E.</creatorcontrib><creatorcontrib>Dieren, S.</creatorcontrib><creatorcontrib>Besselink, M. G.</creatorcontrib><creatorcontrib>Gulik, T. M.</creatorcontrib><creatorcontrib>Koens, L.</creatorcontrib><creatorcontrib>Tanis, P. J.</creatorcontrib><creatorcontrib>Bemelman, W. A.</creatorcontrib><title>Safe, selective histopathological examination of gallbladder specimens: a systematic review</title><title>British journal of surgery</title><addtitle>Br J Surg</addtitle><description>Background
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.
Methods
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.
Results
Seventy‐three studies (232 155 patients) were included. In low‐incidence countries, the pooled incidence was 0·32 (95 per cent c.i. 0·25 to 0·42) per cent for incidental GBC and 0·18 (0·10 to 0·35) per cent for truly incidental GBC. Subgroup analysis of studies in which surgeons systematically examined the gallbladder revealed a pooled incidence of 0·04 (0·01 to 0·14) per cent. In high‐incidence countries, corresponding pooled incidences were 0·83 (0·58 to 1·18), 0·44 (0·21 to 0·91) and 0·08 (0·02 to 0·39) per cent respectively. Clinical consequences were reported for 176 (39·3 per cent) of 448 patients with truly incidental GBC. Thirty‐three patients (18·8 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.
Conclusion
Selective histopathological examination of the gallbladder after initial macroscopic assessment by the surgeon seems safe and could reduce costs.
Antecedentes
El examen histopatológico rutinario después de la colecistectomía es caro y la prevalencia de cáncer de vesícula biliar (gallbladder cancer, GBC) no sospechado o incidental es baja. Este estudio determinó si el examen histológico selectivo es seguro.
Métodos
Se realizó una búsqueda exhaustiva en PubMed, Embase, Web of Science y en la Biblioteca Cochrane. Se estimaron las incidencias agrupadas de GBC incidental y realmente incidental (GBC detectado durante el examen histopatológico sin sospecha previa o intraoperatoria) utilizando un modelo de efectos aleatorios. Además, se evaluaron las consecuencias clínicas del GBC realmente incidental.
Resultados
Se incluyeron 73 estudios (n = 232.155). En los países de baja incidencia, la incidencia agrupada fue de 0,32% para el GBC incidental (i.c. del 95% 0,25 a 0,42) y de 0,18% (0,10 a 0,35) para GBC realmente incidental. El análisis de subgrupos que incluye estudios en los que los cirujanos examinaron sistemáticamente la vesícula biliar reveló una incidencia agrupada de 0,04% (0,01 a 0,14). En los países de alta incidencia, las incidencias agrupadas correspondientes fueron 0,83% (0,58 a 1,18), 0,44% (0.2 a 0.91) y 0,08% (0,02 a 0,39), respectivamente. Se describieron consecuencias clínicas en 176 (39,3%) de 448 pacientes con GBC realmente incidental. Treinta y tres pacientes (18,6%) se sometieron a cirugía secundaria. El análisis por subgrupos mostró que al menos la mitad de los GBC no detectados durante el examen sistemático de la vesícula biliar por parte del cirujano eran tumores de estadio precoz (≤ T1a) y sin consecuencias clínicas.
Conclusión
El examen histológico selectivo de vesículas biliares después de la evaluación macroscópica inicial realizada por el cirujano parece seguro y podría reducir los costes.
This meta‐analysis found that the incidence of truly incidental gallbladder cancer (GBC) was less than 0·5 per cent and decreased to less than 0·1 per cent when the surgeon performed a systematic macroscopic examination. At least 50 per cent of GBC that was not detected before or during surgery was of early stage and with no clinical consequences. Particularly in non‐endemic regions, selective histopathological examination after initital macroscopic assessment of the gallbladder by the surgeon seems safe and will likely result in significant cost and time savings.
Open and palpate it</description><subject>Cholecystectomy</subject><subject>Gallbladder</subject><subject>Gallbladder - pathology</subject><subject>Gallbladder - surgery</subject><subject>Gallbladder cancer</subject><subject>Gallbladder Neoplasms - epidemiology</subject><subject>Gallbladder Neoplasms - pathology</subject><subject>Gallbladder Neoplasms - surgery</subject><subject>Global Health</subject><subject>Histopathology</subject><subject>HPB</subject><subject>Humans</subject><subject>Incidence</subject><subject>Incidental Findings</subject><subject>Models, Statistical</subject><subject>Neoplasm Staging</subject><subject>Patient Safety</subject><subject>Patient Selection</subject><subject>Surgeons</subject><subject>Systematic Review</subject><issn>0007-1323</issn><issn>1365-2168</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>WIN</sourceid><sourceid>EIF</sourceid><recordid>eNpdkc1P3DAQxS1UVLa0B_6BylIvPTTgr9hxD0gUtQWExIFy4mBNnMmuV068xNml-983fBS1nGak99PTm3mEHHB2yBkTR_UyH3JuSrtDZlzqshBcV2_IjDFmCi6F3CPvcl4yxiUrxVuyJ4WWlik7I7fX0OIXmjGiH8MG6SLkMa1gXKSY5sFDpPgbutDDGFJPU0vnEGMdoWlwoHmFPnTY568UaN7mEbuJ83TATcD792S3hZjxw_PcJzc_vv86PSsur36en55cFl4xa4taWtka34qaC91UpZRea14ZK5QqvYAGPatbxFpjpQ3wypbCACgNbYOstXKfHD_5rtZ1h43HfhwgutUQOhi2LkFw_yt9WLh52jhTKqYrPhl8fjYY0t0a8-i6kD3GCD2mdXZCCa605ExM6KdX6DKth346b6KUMEYq_WD48d9EL1H-_n0Cjp6A-xBx-6Jz5h4KdVOh7rFQ9-3i-nGRfwC9lZRl</recordid><startdate>202010</startdate><enddate>202010</enddate><creator>Bastiaenen, V. P.</creator><creator>Tuijp, J. E.</creator><creator>Dieren, S.</creator><creator>Besselink, M. G.</creator><creator>Gulik, T. M.</creator><creator>Koens, L.</creator><creator>Tanis, P. J.</creator><creator>Bemelman, W. A.</creator><general>John Wiley & Sons, Ltd</general><general>Oxford University Press</general><scope>24P</scope><scope>WIN</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>K9.</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-8711-9383</orcidid></search><sort><creationdate>202010</creationdate><title>Safe, selective histopathological examination of gallbladder specimens: a systematic review</title><author>Bastiaenen, V. P. ; Tuijp, J. E. ; Dieren, S. ; Besselink, M. G. ; Gulik, T. M. ; Koens, L. ; Tanis, P. J. ; Bemelman, W. A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4099-b393f7cf2b126d8533c6618792445c2adec0bfeeb6e867a189527aa46afde0f93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Cholecystectomy</topic><topic>Gallbladder</topic><topic>Gallbladder - pathology</topic><topic>Gallbladder - surgery</topic><topic>Gallbladder cancer</topic><topic>Gallbladder Neoplasms - epidemiology</topic><topic>Gallbladder Neoplasms - pathology</topic><topic>Gallbladder Neoplasms - surgery</topic><topic>Global Health</topic><topic>Histopathology</topic><topic>HPB</topic><topic>Humans</topic><topic>Incidence</topic><topic>Incidental Findings</topic><topic>Models, Statistical</topic><topic>Neoplasm Staging</topic><topic>Patient Safety</topic><topic>Patient Selection</topic><topic>Surgeons</topic><topic>Systematic Review</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bastiaenen, V. P.</creatorcontrib><creatorcontrib>Tuijp, J. E.</creatorcontrib><creatorcontrib>Dieren, S.</creatorcontrib><creatorcontrib>Besselink, M. G.</creatorcontrib><creatorcontrib>Gulik, T. M.</creatorcontrib><creatorcontrib>Koens, L.</creatorcontrib><creatorcontrib>Tanis, P. J.</creatorcontrib><creatorcontrib>Bemelman, W. A.</creatorcontrib><collection>Wiley Online Library (Open Access Collection)</collection><collection>Wiley Online Library Free Content</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>British journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bastiaenen, V. P.</au><au>Tuijp, J. E.</au><au>Dieren, S.</au><au>Besselink, M. G.</au><au>Gulik, T. M.</au><au>Koens, L.</au><au>Tanis, P. J.</au><au>Bemelman, W. A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Safe, selective histopathological examination of gallbladder specimens: a systematic review</atitle><jtitle>British journal of surgery</jtitle><addtitle>Br J Surg</addtitle><date>2020-10</date><risdate>2020</risdate><volume>107</volume><issue>11</issue><spage>1414</spage><epage>1428</epage><pages>1414-1428</pages><issn>0007-1323</issn><eissn>1365-2168</eissn><abstract>Background
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.
Methods
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.
Results
Seventy‐three studies (232 155 patients) were included. In low‐incidence countries, the pooled incidence was 0·32 (95 per cent c.i. 0·25 to 0·42) per cent for incidental GBC and 0·18 (0·10 to 0·35) per cent for truly incidental GBC. Subgroup analysis of studies in which surgeons systematically examined the gallbladder revealed a pooled incidence of 0·04 (0·01 to 0·14) per cent. In high‐incidence countries, corresponding pooled incidences were 0·83 (0·58 to 1·18), 0·44 (0·21 to 0·91) and 0·08 (0·02 to 0·39) per cent respectively. Clinical consequences were reported for 176 (39·3 per cent) of 448 patients with truly incidental GBC. Thirty‐three patients (18·8 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.
Conclusion
Selective histopathological examination of the gallbladder after initial macroscopic assessment by the surgeon seems safe and could reduce costs.
Antecedentes
El examen histopatológico rutinario después de la colecistectomía es caro y la prevalencia de cáncer de vesícula biliar (gallbladder cancer, GBC) no sospechado o incidental es baja. Este estudio determinó si el examen histológico selectivo es seguro.
Métodos
Se realizó una búsqueda exhaustiva en PubMed, Embase, Web of Science y en la Biblioteca Cochrane. Se estimaron las incidencias agrupadas de GBC incidental y realmente incidental (GBC detectado durante el examen histopatológico sin sospecha previa o intraoperatoria) utilizando un modelo de efectos aleatorios. Además, se evaluaron las consecuencias clínicas del GBC realmente incidental.
Resultados
Se incluyeron 73 estudios (n = 232.155). En los países de baja incidencia, la incidencia agrupada fue de 0,32% para el GBC incidental (i.c. del 95% 0,25 a 0,42) y de 0,18% (0,10 a 0,35) para GBC realmente incidental. El análisis de subgrupos que incluye estudios en los que los cirujanos examinaron sistemáticamente la vesícula biliar reveló una incidencia agrupada de 0,04% (0,01 a 0,14). En los países de alta incidencia, las incidencias agrupadas correspondientes fueron 0,83% (0,58 a 1,18), 0,44% (0.2 a 0.91) y 0,08% (0,02 a 0,39), respectivamente. Se describieron consecuencias clínicas en 176 (39,3%) de 448 pacientes con GBC realmente incidental. Treinta y tres pacientes (18,6%) se sometieron a cirugía secundaria. El análisis por subgrupos mostró que al menos la mitad de los GBC no detectados durante el examen sistemático de la vesícula biliar por parte del cirujano eran tumores de estadio precoz (≤ T1a) y sin consecuencias clínicas.
Conclusión
El examen histológico selectivo de vesículas biliares después de la evaluación macroscópica inicial realizada por el cirujano parece seguro y podría reducir los costes.
This meta‐analysis found that the incidence of truly incidental gallbladder cancer (GBC) was less than 0·5 per cent and decreased to less than 0·1 per cent when the surgeon performed a systematic macroscopic examination. At least 50 per cent of GBC that was not detected before or during surgery was of early stage and with no clinical consequences. Particularly in non‐endemic regions, selective histopathological examination after initital macroscopic assessment of the gallbladder by the surgeon seems safe and will likely result in significant cost and time savings.
Open and palpate it</abstract><cop>Chichester, UK</cop><pub>John Wiley & Sons, Ltd</pub><pmid>32639049</pmid><doi>10.1002/bjs.11759</doi><tpages>15</tpages><orcidid>https://orcid.org/0000-0002-8711-9383</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0007-1323 |
| ispartof | British journal of surgery, 2020-10, Vol.107 (11), p.1414-1428 |
| issn | 0007-1323 1365-2168 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7540681 |
| source | MEDLINE; Access via Wiley Online Library; Oxford University Press Journals All Titles (1996-Current) |
| subjects | Cholecystectomy Gallbladder Gallbladder - pathology Gallbladder - surgery Gallbladder cancer Gallbladder Neoplasms - epidemiology Gallbladder Neoplasms - pathology Gallbladder Neoplasms - surgery Global Health Histopathology HPB Humans Incidence Incidental Findings Models, Statistical Neoplasm Staging Patient Safety Patient Selection Surgeons Systematic Review |
| title | Safe, selective histopathological examination of gallbladder specimens: a systematic review |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-22T12%3A45%3A52IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Safe,%20selective%20histopathological%20examination%20of%20gallbladder%20specimens:%20a%20systematic%20review&rft.jtitle=British%20journal%20of%20surgery&rft.au=Bastiaenen,%20V.%20P.&rft.date=2020-10&rft.volume=107&rft.issue=11&rft.spage=1414&rft.epage=1428&rft.pages=1414-1428&rft.issn=0007-1323&rft.eissn=1365-2168&rft_id=info:doi/10.1002/bjs.11759&rft_dat=%3Cproquest_pubme%3E2442773461%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2442773461&rft_id=info:pmid/32639049&rfr_iscdi=true |