TPT 8.01 Routine Versus Selective Histopathological Analysis of Gallbladder Specimen: A Regional Survey of Pathologists and Surgeons

Abstract Aims Routine histopathological examination of gallbladder (GB) specimens following cholecystectomy remains standard practice in many centres, despite low incidence of GB cancer. The survey evaluated current regional practice and explored the perspectives of consultant pathologists and surgeons regarding routine versus selective GB histological analysis. Methods Two separate surveys were conducted across the Yorkshire region and beyond: one for consultant pathologists and one for surgeons. Structured questionnaires assessed current practice and attitudes towards routine versus selective GB histopathological submission. Results Responses were received from 15 pathologists and 36 surgeons. Among pathologists, 60% (9/15) supported routine histological analysis of all GB specimens. However, a selective approach was considered in cases with abnormal macroscopic appearance, including GB wall thickening, polyps, focal lesions or suspicion of malignancy. One-third of pathologists supported surgeons opening the specimen for inspection prior to submission. Among surgeons, 67% (24/36) favoured routine histology. Indications cited for selective histological analysis included focal GB abnormalities, porcelain GB, polyps and suspected malignancy. Sixty percent of surgeons reported routinely or selectively opening the GB specimen prior to histological submission. Within the selective group, GB abnormalities, polyps, operative difficulty and suspected malignancy were identified as indications for opening the GB prior to submission for histological examination. Conclusion Although routine GB histopathology examination remains the dominant practice, both surgeons and pathologists indicated the potential utility of a selective approach. A regionally agreed, evidence-based selective histology protocol may facilitate safe implementation, provided that standardised selection criteria, comprehensive governance frameworks and appropriate medico-legal safeguards are in place.