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- Title
Selective Histological Examination After Cholecystectomy: An Analysis of Current Daily Practice in The Netherlands.
- Authors
Corten, B. J. G. A.; Leclercq, W. K. G.; Dejong, C. H.; Roumen, R. M. H.; Slooter, G. D.
- Abstract
Background: The 2016 Dutch national guidelines on handling of a removed gallbladder for cholelithiasis proposes a selective histopathologic policy (Sel-HP) rather than routine policy (Rout-HP). The aim of this study was to determine the current implementation of the present guideline and the daily practice of Sel-HP. Methods: Surgeons who were engaged in gallbladder surgery in the Netherlands and were involved in local hospitals' gallbladder protocols completed a questionnaire study regarding gallbladder policy, between December 2017 and May 2018. Data were analyzed using standard statistics. Results: A 100% response rate was obtained (n = 74). Approximately 64% of all gallbladders (n = 22,500) were examined microscopically. Sixty-nine (93.2%) hospitals confirmed they were aware of the new guidelines, and 56 (75.7%) knew the guideline was adjusted in favor of Sel-HP. Half of the hospitals (n = 35, 47.3%) had adopted a Sel-HP, and 39 (52.7%) a Rout-HP. Of the 39 hospitals who had a Rout-HP, 36 were open to a transition to a Sel-HP although some expressed the need for more evidence on safety or novel guidelines. Conclusions: The current implementation of the 2016 Dutch guideline advising a selective microscopic analysis of removed gallbladders for gallstone disease is suboptimal. Evidence demonstrating safety and cost-effectiveness of an on demand histopathological examination will aid in the implementation process.
- Subjects
NETHERLANDS; GALLSTONES; CHOLECYSTECTOMY; GALLBLADDER surgery; MICROSCOPY; GALLBLADDER; MEDICAL care surveys
- Publication
World Journal of Surgery, 2019, Vol 43, Issue 10, p2561
- ISSN
0364-2313
- Publication type
Article
- DOI
10.1007/s00268-019-05077-w