Incidence and clinicopathological features of incidental gallbladder cancer.

Introduction: Annually, more than 9,000 cholecystectomies are performed in Denmark. All gallbladders are submitted for histological examination to rule out preoperatively undetected gallbladder cancer. The histological examination at the Department of Pathology is costly. Therefore, it is relevant to investigate whether adopting a selective approach in which only selected gallbladders are submitted for histological examination is reasonable.

Methods: All cholecystectomies submitted for histological examination at the Department of Pathology at Herlev Hospital from 1 January 2014 to 31 December 2023 were included in the study. In cases of gallbladder cancer, the results of the preoperative diagnostic imaging, intraoperative findings and the macroscopic examination at the Department of Pathology were systematically reviewed.

Results: In total, 9,698 gallbladders were included in the study. Across all patients, the incidence of gallbladder cancer was 0.29%, with a total of 28 cases being identified. In patients ≤ 60 years, the incidence of gallbladder cancer was 0.08%, whereas the incidence of gallbladder cancer was 0.67% in patients > 60 years. Among the 28 cases of gallbladder cancer, the surgeon noted macroscopic changes in 27 cases, while such changes were observed in all cases during the macroscopic examination at the Department of Pathology.

Conclusion: The study supports implementing a selective approach to histopathological examination of the gallbladder after cholecystectomy but also emphasises the need for a thorough macroscopic examination.

Funding: None.

Trial registration: Not relevant.