Author/Editor		Pospihalj, Boris; Kadiš, Peter; Zupančič, Marko
Title		Zanesljivost makroskopske opredelitve tumorskega procesa v steni žolčnika: ali naj na patohistološko preiskavo pošiljamo tudi vse na tumorsko patologijo nesumljive žolčnike?
Translated title		Accuracy of macroscopical assessment of gallbladder pathology: should we send all macroscopically benign gallbladders on pathological examination?
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 74, št. 3
Publication year		2005
Volume		str. 147-51
Language		slo
Abstract		Background. Gallbladder stones are the main reason for numerous gallbladder removal procedures. In many cases it is impossible to discover gallbladder carcinoma during the preoperative workup. Diffuse gallbladder wall thickening is usually the result of gallstones but may harbour carcinoma as well. The objective of our study was to estimate the accuracy of the intraoperative macroscopic examination for determination of a pathological process of the gallbladder. Methods. We retrospectively examined 25 cases of the gallbladder carcinoma found in 4288 patients who underwent cholecystectomy in the period from 1993 to 2004. In each of those cases we determined whether a suspicion for carcinoma has been reported based on macroscopic examination. Results. According to macroscopic examination of the gallbladder surgeon did not report any suspicion for the carcinoma in 52% of the cases. Conclusions. Due to high inaccuracy of preoperative and intraoperative macroscopical assessment, pathological examination of the resected gallbladder is the only accurate method for the diagnosis of gallbladder carcinoma, as well as for staging and establishing the indication for extended surgical procedure.
Summary		Izhodišča. Žolčni kamni so danes osnovni razlog za množično operativno odstranitev žolčnikov. V mnogih primerih med predoperativrto diagnostiko ni mogoče posumiti na karcinom žolčnika. Preslepi nas lahko tudi prisotnost difuzne zadebelitve stene žolčnika, ki je pogosto posledica žolčnih kamnov, lahko pa hkrati skriva karcinom. Namen prispevka je oceniti zanesljivost makroskopske presoje pri določanju narave patološkega procesa žolčnika. Metode. Retrospektivrto smo pregledali 25 primerov karcinoma žolčnika, ki smo jih v obdobju 1993-2004 odkrili na seriji 4288 reseciranih žolčnikih. Pri slehernem primeru smo ocenili, ali je bil na podlagi makroskopskega pregleda izražen sum na karcinom. Rezultati. Na podlagi makroskopskega pregleda žolčnika operater ni posumil na karcinom žolčnika v 52% primerov. Zaključki. Edina možnost, da ob tako visoki nezanesljivosti makroskopske presoje postavimo diagnozo karcinoma žolčnika, je patohistološka preiskava, na podlagi katere lahko ocenimo stadij bolezni in načrtujemo morebitni razširjeni poseg.
Descriptors		GALLBLADDER NEOPLASMS NEOPLASM STAGING CHOLELITHIASIS RETROSPECTIVE STUDIES