YOZGAT ŞEHİR HASTANESİNDE SON 5 YILDA UYGULANAN KOLESİSTEKTOMİ SPESİMENLERİNİN MORFOLOJİK VE HİSTOPATOLOJİK ÖZELLİKLERİNİN RETROSPEKTİF DEĞERLENDİRİLMESİ Retrospective Evaluation Of Morphological And Histopathological Features Of Cholecystectomy Specimens Performed İn Yozgat City Hospital For The Past 5 Years

OZET Amac: Kolesistektomi ikinci basamak devlet hastaneleri Genel Cerrahi servislerinde en sik uygulanan ameliyatlarin basinda gelmektedir. Kolesistektomi spesimenlerinin histopatolojik degerlendirilmesi literaturde yaygin olarak ele alinmistir. Ancak morfolojik degerlendirme oldukca kisitlidir. Bu calisma ile semptomatik benign hastaliklar nedeniyle kolesistektomi yapilan hastalarin kolesistektomi spesimenlerinin mikroskobik ve makroskopik ozelliklerinin yani sira morfolojik ozelliklerinin de degerlendirilmesi amaclandi. Gerec ve Yontem: Yozgat Şehir Hastanesinde Ocak 2014 ve Mart 2019 tarihleri arasinda Genel Cerrahi Servisinde gerceklestirilen toplam 961 kolesistektomi spesimeni geriye donuk incelendi. Calisma hastane elektronik verilerinden hasta bilgilerine ulasilarak geriye donuk gerceklestirildi. Hastalarin yas, cinsiyet, uygulanan ameliyatin sekli, histopatolojik tani, safra tasinin olup olmadigi, kolesistektomi spesimenin uzunlugu, genisligi ve en kalin duvar olculeri degerlendirmeye alindi. Bulgular: Toplam 961 hastanin 734’u (%76,4) kadin, 227’si (%23,6) erkeklerden olusmaktaydi. Ameliyatlarin 900 tanesi laparoskopik olarak (%93,7) gerceklestirildi. Safra kesesi genisligi acisindan her iki cinsiyet arasinda anlamli fark saptanmazken (p=0,23), safra kesesi uzunlugu (p=0,04), safra kesesi duvar kalinliginin (p=0,001) erkeklerde fazla oldugu saptandi. Kronik kolesistit kadinlarda, subakut ve akut kolesistit erkeklerde daha sik goruldu (p=0,001). Kolelitiazis ve kolesterol oranlarina cinsiyetin etkisi saptanmadi (p=0,63). Spesimenlerin % 14,4’de makroskopik bulgular hakkinda raporlama yoktu. Toplam uc spesimende malignite ve uc spesimende neoplastik polip saptandi. Sonuc: Insidental safra kesesi karsinomu ikinci basamak hastanelerde daha sik karsilasilmaktadir. Bu yuzden bu tur hastanelerde rutin olarak kolesistektomi spesimenleri histopatolojik degerlendirmeye gonderilmelidir. Gonderilen spesimenlerinde daha saglikli mikroskobik, makroskopik ve morfolojik ozelliklerinin degerlendirilmesi icin standardize edilmis patoloji raporlamasina ihtiyac vardir. Anahtar Kelimeler: Kolesistektomi; Insidental kanser; Histopatoloji inceleme; Safra kesesi morfolojisi. ABSTRACT Aim: The cholecystectomy is one of the most common operations performed in the general surgery department of secondary level hospitals. Histopathological evaluation of cholecystectomy specimens has been widely discussed in the literature. However, morphological evaluation is very limited. The aim of this study is to evaluate the morphological features besides the microscopic and macroscopic features of specimens performed cholecystectomy because of symptomatic benign diseases. Material and Methods: A total of 961 cholecystectomy specimens were examined from January 2014 and to 2019 in the General Surgery Department at Yozgat City Hospital. The study was conducted retrospectively by accessing patient information from the hospital electronic data. Age, sex, type of surgery, histopathological diagnosis, presence of gallstones, length, width and thickest wall measurements of cholecystectomy specimens were evaluated. Results: Of the total 961 patients, 734 (76.4%) were female and 227 (23.6%) were male. 900 of them were performed laparoscopically (93.7%). There was no significant difference between the two genders in terms of gallbladder width (p = 0.23), but gallbladder length (p = 0.04) and gallbladder wall thickness (p = 0.001) were higher in males. Chronic cholecystitis was more common in women and subacute and acute cholecystitis in men (p = 0.001). There was no effect of gender on cholelithiasis and cholesterol ratio (p = 0.63). There were no reports on macroscopic findings in 14.4% of specimens. Malignancy was detected in three specimens and neoplastic polyp was detected in three specimens. Conclusions: Incidental gallbladder carcinoma is more common in secondary level hospitals. Therefore, cholecystectomy specimens should be routinely sent for histopathological evaluation, especially in such hospitals. A standardized reporting is needed to evaluate the properly microscopic, macroscopic and morphological characteristics of the specimens. Key words: Cholecystectomy; Incidental cancer; Histopathology examination; Gallbladder morphology.