Evidence map›Paper›PMID 32639049›Full record

SynthesisThe British journal of surgery2020

Safe, selective histopathological examination of gallbladder specimens: a systematic review.

V P Bastiaenen, J E Tuijp, S van Dieren, M G Besselink, T M van Gulik, L Koens, P J Tanis, W A Bemelman

Abstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in The British journal of surgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Incidental Gallbladder Cancer: A Comprehensive Review.Journal of gastrointestinal cancer · 2025
    Review
  2. Article
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors.

V P BastiaenenDepartment of Surgery, Cancer Centre Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands.ORCID 0000-0002-8711-9383
J E TuijpDepartment of Surgery, Cancer Centre Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands.
S van DierenDepartment of Surgery, Cancer Centre Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands.
M G BesselinkDepartment of Surgery, Cancer Centre Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands.
T M van GulikDepartment of Surgery, Cancer Centre Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands.
L KoensDepartment of Pathology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
P J TanisDepartment of Surgery, Cancer Centre Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands.
W A BemelmanDepartment of Surgery, Cancer Centre Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRoutine histopathological examination after cholecystectomy is costly, but the prevalence of unsuspected gallbladder cancer (incidental GBC) is low. This study determined whether selective histopathological examination is safe.

methodsA comprehensive search of PubMed, Embase, Web of Science and the Cochrane Library was performed. Pooled incidences of incidental and truly incidental GBC (GBC detected during histopathological examination without preoperative or intraoperative suspicion) were estimated using a random-effects model. The clinical consequences of truly incidental GBC were assessed.

resultsSeventy-three studies (232 155 patients) were included. In low-incidence countries, the pooled incidence was 0·32 (95 per cent c.i. 0·25 to 0·42) per cent for incidental GBC and 0·18 (0·10 to 0·35) per cent for truly incidental GBC. Subgroup analysis of studies in which surgeons systematically examined the gallbladder revealed a pooled incidence of 0·04 (0·01 to 0·14) per cent. In high-incidence countries, corresponding pooled incidences were 0·83 (0·58 to 1·18), 0·44 (0·21 to 0·91) and 0·08 (0·02 to 0·39) per cent respectively. Clinical consequences were reported for 176 (39·3 per cent) of 448 patients with truly incidental GBC. Thirty-three patients (18·8 per cent) underwent secondary surgery. Subgroup analysis showed that at least half of GBC not detected during the surgeon's systematic examination of the gallbladder was early stage (T1a status or below) and of no clinical consequence.

conclusionSelective histopathological examination of the gallbladder after initial macroscopic assessment by the surgeon seems safe and could reduce costs.

Indexed as

CholecystectomyIncidental FindingsGallbladderGallbladder NeoplasmsGlobal HealthHumansIncidenceModels, StatisticalNeoplasm StagingPatient SafetyPatient Selection

Identifiers

PMID32639049
PMCPMC7540681

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.