Evidence map›Paper›PMID 35245363›Full record

ArticleThe British journal of surgery2022

Safety and economic analysis of selective histopathology following cholecystectomy: multicentre, prospective, cross-sectional FANCY study.

Vivian P Bastiaenen, Jaap L P van Vliet, Elise A J de Savornin Lohman, Bartholomeus J G A Corten, Joske de Jonge, Anne C Kraima, Hilko A Swank, Gijs J D van Acker, Anna A W van Geloven, Klaas H In 't Hof and 9 more

Open access · bronzeAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in The British journal of surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 2 pooled it
0.9field-weighted citation impact, top 24% of its field
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

4 citing papers in PubMed, 2 syntheses or guidelines pooled it, 10 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

19 authors at 7 institutions in 1 country.

Vivian P BastiaenenDepartment of Surgery, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands.ORCID 0000-0002-8711-9383
Jaap L P van VlietDepartment of Surgery, Haaglanden Medical Centre, 2512 VA The Hague, The Netherlands.
Elise A J de Savornin LohmanDepartment of Surgery, Radboud University Medical Centre, 6525 GA Nijmegen, The Netherlands.
Bartholomeus J G A CortenDepartment of Surgery, Máxima Medical Centre, 5504 DB Veldhoven, The Netherlands.
Joske de JongeDepartment of Surgery, Tergooi Hospital, 1213 XZ Hilversum, The Netherlands.
Anne C KraimaDepartment of Surgery, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands.
Hilko A SwankDepartment of Surgery, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands.
Gijs J D van AckerDepartment of Surgery, Haaglanden Medical Centre, 2512 VA The Hague, The Netherlands.
Anna A W van GelovenDepartment of Surgery, Tergooi Hospital, 1213 XZ Hilversum, The Netherlands.
Klaas H In 't HofDepartment of Surgery, Flevo Hospital, 1315 RA Almere, The Netherlands.
Lianne KoensDepartment of Pathology, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands.
Philip R de ReuverDepartment of Surgery, Radboud University Medical Centre, 6525 GA Nijmegen, The Netherlands.
Charles C van RossemDepartment of Surgery, Maasstad Hospital, 3079 DZ Rotterdam, The Netherlands.
Gerrit D SlooterDepartment of Surgery, Máxima Medical Centre, 5504 DB Veldhoven, The Netherlands.
Pieter J TanisDepartment of Surgery, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands.ORCID 0000-0002-3146-3310
Valeska TerpstraDepartment of Pathology, Haaglanden Medical Centre, 2512 VA The Hague, The Netherlands.
Marcel G W DijkgraafDepartment of Epidemiology and Data Science, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands.
Willem A BemelmanDepartment of Surgery, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands.
Dutch Snapshot Research Group
Amsterdam University Medical Centers · NLRadboud University Nijmegen · NLMedisch Centrum Haaglanden · NLAlbert Schweitzer Ziekenhuis · NLTergooi · NLDe Kinderkliniek · NLMaasstad Ziekenhuis · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThere is ongoing debate concerning the necessity of routine histopathological examination following cholecystectomy. In order to reduce the pathology workload and save costs, a selective approach has been suggested, but evidence regarding its oncological safety is lacking.

methodsIn this multicentre, prospective, cross-sectional study, all gallbladders removed for gallstone disease or cholecystitis were systematically examined by the surgeon for macroscopic abnormalities indicative of malignancy. Before sending all specimens to the pathologist, the surgeon judged whether histopathological examination was indicated. The main outcomes were the number of patients with hypothetically missed malignancy with clinical consequences (upper limit two-sided 95 per cent c.i. below 3:1000 considered oncologically safe) and potential cost savings of selective histopathological examination.

resultsTwenty-two (2.19:1000) of 10 041 specimens exhibited malignancy with clinical consequences. In case of a selective policy, surgeons would have held back 7846 of 10041 (78.1 per cent) gallbladders from histopathological examination. Malignancy with clinical consequences would have been missed in seven of 7846 patients (0.89:1000, upper limit 95% c.i. 1.40:1000). No patient benefitted from the clinical consequences, while two were harmed (futile additional surgery). Of 15 patients in whom malignancy with clinical consequences would have been diagnosed, one benefitted (residual disease radically removed), two potentially benefitted (palliative systemic therapy), and four experienced harm (futile additional surgery). Estimated cost savings established by replacing routine for selective histopathological examination were €703 500 per 10 000 patients.

conclusionSelective histopathological examination following cholecystectomy is oncologically safe and could reduce pathology workload, costs, and futile re-resections.

Indexed as

Gallbladder NeoplasmsCholecystectomyCost SavingsCross-Sectional StudiesHumansProspective Studies

Identifiers

PMID35245363
PMCPMC10364776
OpenAlexW4205532129

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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.