Gallbladder grossing

Schematic of a gallbladder. (WC/Madhero88)

This article covers gallbladder grossing, also cholecystectomy specimens.

Introduction

These specimens are very common and could be classified as a ditzel.

Cholecystectomies are usually done for chronic cholecystitis (increasingly common in western countries due to the increasing prevalence of obesity). Less common indications are acute cholecystitis and gallstones (may cause gallstone pancreatitis, Mirizzi syndrome).

Specimen opening

These are not routinely opened before cut-up.

Protocol

• Specimen: Gallbladder.
• Received: [intact/opened/open with defect measuring ___ cm].

Dimensions:

• External dimensions: ___ cm length, ___ cm diameter.
• Wall thickness (maximal): ___ cm.

Appearance:

• Serosal surface: [tan and smooth/rough].
• Lumen contains: [thick green bile/multiple [yellow/green/black] calculi].
• Mucosa: [dark green and velvety/granular, hemorrhagic/strawberry-like].
• Polyp/tumour: [not identified/___ cm in maximal dimension].
• Wall: [pliable/firm].
• Neck: [pliable/firm].
• Cystic duct: [patent/not patent].
• Cystic duct lymph node: [not identified/present, measuring ___ cm in greatest dimension].

Sections:

• Representive sections of the neck, body and fundus, including the cystic duct lymph node, are submitted in one cassette.

Protocol notes

• Intestinal metaplasia of the gallbladder does not have to be submitted in total.
• High-grade dysplasia should prompt submitting the gallbladder in total, if cancer is not present.