Yıl 2017, Cilt 9, Sayı 3, Sayfalar 243 - 249 2017-09-22

Kolesistektomi sonrası rutin histopatlojik safra kesesi incelemesi gerekli mi?: Tek merkezdeki 1366 kolesistektomi spesmeninin sonuçlarının değerlendirilmesi
Is Routine Histopathological Gallbladder Examination Necessary After Cholecystectomy? Evaluation of the Results of 1,366 Cholecystectomy Specimens in Single Center

Erdal Uysal [1] , Efe Sezgin [2] , Hasan Bakır [3] , Ahmet Gurer [4] , Mehmet Sokucu [5]

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Amaç: Kolesistektomi sonrası rutin olarak yapılan histopatolojik inceleme sonuçlarının değerlendirilmesi, kolesistektomiler sonrası rutin histopatolojik incelemenin gerekliliğini araştırmak amaçlanmıştır.

Gereç ve Yöntem: Çalışma retrospektif olarak dizayn edilmiştir. Bening safra kesesi hastalığı ön tanısı ile Kasım 2011- Mayıs 2017 yılları arasında merkezimizde Laparaskopik ve açık kolesistektomi uygulanan 1366 hasta çalışmaya dahil edildi. Hastaların demografik verileri, patoloji sonuçları, spesmenin makroskopik görünümü, kanser evrelemesi kayıt edildi. Patolojik tanıların dağılımı ve sıklığı, incidental safra kesesi kanseri prevalansı değerlendirildi.

Bulgular: Çalışmaya dahil edilen hasta sayısı 1366 idi. Hastaların 1303 (%95)’ü kronik kolesistit, 39 (%3)’u akut kolesistit, 7 (%0.5)’i safra kesesi kanseri, 17 (%1.5) hastada diğer tanılar tespit edildi. Gruplar arasında yaş ortalaması açısından istatistiksel anlamlılık saptandı (p=0.0002). Kolesterolizis açısından gruplar arasında yapılan karşılaştırmalarda istatistiksel olarak anlamlılık bulundu (p=0.0003). Mukoza atrofisi ile cinsiyet arasında anlamlı ilişki tespit edildi (p=0.001).

Tartışma: Safra kesesi spesmenlerinin histopatolojik incelenmesinde en sık görülen tanı kronik kolesistitdir. Ancak kolesistektomi sonrası, safra kesesinin histopatolojik spekturumu oldukça geniştir. İncidental safra kesesi tümörleri preoperative görüntüleme yöntemleri ile tespit edilemeyebilir. İncidental safra kesesi tümörleri genellikle asemptomtomatik seyretmektedir. Çalışmamızda T2, T3 ve T4 safra kesesi tümörlerine de rastlanılmıştır. Bu hastaların tümüne ek girişimler gerekmiştir. Rutin histopatolojik inceleme yokluğunda, tedavi planı yapılamadığından metastatic ileri evre safra kesesi tümörleriyle karşılaşılabilir. Bu nedenle rutin histopatolojik incelemenin yapılmasını önermekteyiz.


Objective: it was aimed to evaluate the results of routine histopathological examination after cholecystectomy and to investigate the necessity of routine histopathologic examination after cholecystectomy.


 Methods: The study was designed retrospectively. 1366 patients who underwent laparoscopic and open cholecystectomy at our center with pre-diagnosis of benign gallbladder disease between November 2011 and May 2017were included in the study. Patients' demographic data, pathologic results, macroscopic appearance of the specimen, and cancer staging were recorded. The distribution and frequency of pathologic diagnoses and the prevalence of incidental gallbladder cancer (GBC) were evaluated. Pathologic findings were compared in terms of age groups and gender relations.


Results: The number of patients included in the study was 1,366. 1,303 patients (95%) were diagnosed with chronic cholecystitis, 39 (3%) with acute cholecystitis, 7 (0.5%) with  GBC, and 17 (1.5%) with other diagnoses of the patients. Statistical significance was found between the groups in terms of the mean age (p = 0.0002). Comparisons between groups in terms of cholesterolysis were statistically significant (p = 0.0003). There was a significant relationship between mucosa atrophy and gender (p = 0.001).


Discussion: The histopathological spectrum of gallbladder is quite extensive. Incidental GBC may not be detected by preoperative imaging methods. Incidental GBC are usually asymptomatic. T2, T3 and T4 GBC were also encountered in our study. All of these patients need additional operations. In the absence of routine histopathologic examination, metastatic advanced GBC may be encountered because no treatment plans could make. Thus, we do recommend routine histopathological examination.


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Konular Sağlık Bilimleri
Dergi Bölümü Makaleler
Yazarlar

Yazar: Erdal Uysal
E-posta: drerdaluysal@hotmail.com
Kurum: Sanko University, School of Medicine Department of General Surgery
Ülke: Turkey


Yazar: Efe Sezgin
E-posta: efeszgn0@gmail.com
Kurum: Izmir Institute of Technology, Engineering Faculty, Department of Food Engineering

Yazar: Hasan Bakır
E-posta: hbakir59@hotmail.com
Kurum: Sanko University School of Medicine, Department of General Surgery

Yazar: Ahmet Gurer
E-posta: ahmet_gurer@yahoo.com
Kurum: Sanko Hospital, Department of General Surgery

Yazar: Mehmet Sokucu
E-posta: msokucu@sankotip.com
Kurum: Sanko University School of Medicine, Department of Pathology

Bibtex @araştırma makalesi { ktd325651, journal = {Konuralp Tıp Dergisi}, issn = {1309-3878}, address = {Düzce Üniversitesi}, year = {2017}, volume = {9}, pages = {243 - 249}, doi = {10.18521/ktd.325651}, title = {Is Routine Histopathological Gallbladder Examination Necessary After Cholecystectomy? Evaluation of the Results of 1,366 Cholecystectomy Specimens in Single Center}, key = {cite}, author = {Sokucu, Mehmet and Bakır, Hasan and Uysal, Erdal and Sezgin, Efe and Gurer, Ahmet} }
APA Uysal, E , Sezgin, E , Bakır, H , Gurer, A , Sokucu, M . (2017). Is Routine Histopathological Gallbladder Examination Necessary After Cholecystectomy? Evaluation of the Results of 1,366 Cholecystectomy Specimens in Single Center. Konuralp Tıp Dergisi, 9 (3), 243-249. DOI: 10.18521/ktd.325651
MLA Uysal, E , Sezgin, E , Bakır, H , Gurer, A , Sokucu, M . "Is Routine Histopathological Gallbladder Examination Necessary After Cholecystectomy? Evaluation of the Results of 1,366 Cholecystectomy Specimens in Single Center". Konuralp Tıp Dergisi 9 (2017): 243-249 <http://dergipark.gov.tr/ktd/issue/32172/325651>
Chicago Uysal, E , Sezgin, E , Bakır, H , Gurer, A , Sokucu, M . "Is Routine Histopathological Gallbladder Examination Necessary After Cholecystectomy? Evaluation of the Results of 1,366 Cholecystectomy Specimens in Single Center". Konuralp Tıp Dergisi 9 (2017): 243-249
RIS TY - JOUR T1 - Is Routine Histopathological Gallbladder Examination Necessary After Cholecystectomy? Evaluation of the Results of 1,366 Cholecystectomy Specimens in Single Center AU - Erdal Uysal , Efe Sezgin , Hasan Bakır , Ahmet Gurer , Mehmet Sokucu Y1 - 2017 PY - 2017 N1 - doi: 10.18521/ktd.325651 DO - 10.18521/ktd.325651 T2 - Konuralp Tıp Dergisi JF - Journal JO - JOR SP - 243 EP - 249 VL - 9 IS - 3 SN - 1309-3878-1309-3878 M3 - doi: 10.18521/ktd.325651 UR - http://dx.doi.org/10.18521/ktd.325651 Y2 - 2017 ER -
EndNote %0 Konuralp Tıp Dergisi Is Routine Histopathological Gallbladder Examination Necessary After Cholecystectomy? Evaluation of the Results of 1,366 Cholecystectomy Specimens in Single Center %A Erdal Uysal , Efe Sezgin , Hasan Bakır , Ahmet Gurer , Mehmet Sokucu %T Is Routine Histopathological Gallbladder Examination Necessary After Cholecystectomy? Evaluation of the Results of 1,366 Cholecystectomy Specimens in Single Center %D 2017 %J Konuralp Tıp Dergisi %P 1309-3878-1309-3878 %V 9 %N 3 %R doi: 10.18521/ktd.325651 %U 10.18521/ktd.325651