دورية أكاديمية
أعرض في EDS

Surgical management of suspected gallbladder cancer: The role of intraoperative frozen section for diagnostic confirmation.

التفاصيل البيبلوغرافية
العنوان: Surgical management of suspected gallbladder cancer: The role of intraoperative frozen section for diagnostic confirmation.
المؤلفون: Chan BKY; Department of Hepato-Biliary Surgery, Aintree University Hospital, Liverpool University Hospitals NHS Foundation Trust, Liverpool, England.; Department of Clinical Pharmacology and Therapeutics, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, England., Carrion-Alvarez L; Department of Hepato-Biliary Surgery, Aintree University Hospital, Liverpool University Hospitals NHS Foundation Trust, Liverpool, England.; Department of Hepato-Pancreato-Biliary Surgery, Hospital Universitario de Fuenlabrada, Madrid, Spain., Telfer R; Department of Hepato-Biliary Surgery, Aintree University Hospital, Liverpool University Hospitals NHS Foundation Trust, Liverpool, England., Rehman AH; Department of Hepato-Biliary Surgery, Aintree University Hospital, Liverpool University Hospitals NHS Foundation Trust, Liverpool, England.; Department of Clinical Pharmacology and Therapeutics, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, England., Bird N; Department of Hepato-Biliary Surgery, Aintree University Hospital, Liverpool University Hospitals NHS Foundation Trust, Liverpool, England., Mann K; Department of Pancreato-Biliary Surgery, Royal Liverpool University Hospital, Liverpool University Hospitals NHS Foundation Trust, Liverpool, England., Jones RP; Department of Hepato-Biliary Surgery, Aintree University Hospital, Liverpool University Hospitals NHS Foundation Trust, Liverpool, England., Malik HZ; Department of Hepato-Biliary Surgery, Aintree University Hospital, Liverpool University Hospitals NHS Foundation Trust, Liverpool, England., Fenwick SW; Department of Hepato-Biliary Surgery, Aintree University Hospital, Liverpool University Hospitals NHS Foundation Trust, Liverpool, England., Diaz-Nieto R; Department of Hepato-Biliary Surgery, Aintree University Hospital, Liverpool University Hospitals NHS Foundation Trust, Liverpool, England.
المصدر: Journal of surgical oncology [J Surg Oncol] 2022 Mar; Vol. 125 (3), pp. 399-404. Date of Electronic Publication: 2021 Oct 24.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Wiley-Liss Country of Publication: United States NLM ID: 0222643 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1096-9098 (Electronic) Linking ISSN: 00224790 NLM ISO Abbreviation: J Surg Oncol Subsets: MEDLINE
أسماء مطبوعة: Publication: <2005-> : Hoboken, NJ : Wiley-Liss
Original Publication: New York, Plenum.
مواضيع طبية MeSH: Cholecystectomy* , Frozen Sections*, Carcinoma/*pathology , Carcinoma/*surgery , Gallbladder Neoplasms/*pathology , Gallbladder Neoplasms/*surgery, Aged ; Carcinoma/mortality ; Female ; Gallbladder Neoplasms/mortality ; Humans ; Lymphoma/mortality ; Lymphoma/pathology ; Lymphoma/surgery ; Male ; Melanoma/mortality ; Melanoma/pathology ; Melanoma/surgery ; Middle Aged ; Neoplasm Staging ; Operative Time ; Retrospective Studies ; Sensitivity and Specificity ; Survival Rate
مستخلص: Background: Preoperative diagnosis for suspected gallbladder cancers is challenging, with a risk of overtreating benign disease, for example, xanthogranulomatous cholecystitis, with radical cholecystectomies. We retrospectively evaluated the surgeon's intraoperative assessment alone, and with the addition of intraoperative frozen sections, for suspected gallbladder cancers from a tertiary hepatobiliary multidisciplinary team (MDT).
Methods: MDT patients with complex gallbladder disease were included. Collated data included demographics, MDT discussion, operative details, and patient outcomes.
Results: A total of 454 patients with complex gallbladder disease were reviewed, 48 (10.6%) were offered radical surgery for suspected cancer. Twenty-five underwent frozen section that led to radical surgery in 6 (25%). All frozen sections were congruent with final histopathology but doubled the operating time (p < 0.0001). Both the surgeon's subjective and additional frozen section's objective assessment, allowed for de-escalation of unnecessary radical surgery, comparing favourably to a 13.0% cancer diagnosis among radical surgery historically.
Conclusions: The MDT process was highly sensitive in identifying gallbladder cancers but lacked specificity. The surgeon's intraoperative assessment is paramount in suspected cancers, and deescalated unnecessary radical surgery. Intraoperative frozen section was a safe and viable adjunct at a cost of resources and operative time.
(© 2021 The Authors. Journal of Surgical Oncology published by Wiley Periodicals LLC.)
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معلومات مُعتمدة: MR/N025989/1 United Kingdom Medical Research Council
فهرسة مساهمة: Keywords: frozen section; gallbladder cancer; intraoperative assessment; radical cholecystectomy
تواريخ الأحداث: Date Created: 20211024 Date Completed: 20220204 Latest Revision: 20220204
رمز التحديث: 20240628
DOI: 10.1002/jso.26726
PMID: 34689332
قاعدة البيانات: MEDLINE
الوصف
تدمد:1096-9098
DOI:10.1002/jso.26726