Publication:

Incidental carcinoma of gallbladder in north India: is routine histopathology of all cholecystectomy specimens justified?

Background Gallstones can cause varied spectrum of histopathology. Xanthogranulomatous cholecystitis and metaplasia have been shown to have association with carcinoma gallbladder. Incidental carcinoma of the gallbladder is a nightmare for the patient. Routine histopathology of all cholecystectomy specimens is an effective policy for its early diagnosis and management.

Methods It is a retrospective study of histopathology of cholecystectomy specimens related to gallstones disease done at a rural government in north India. All patients with preoperative or intraoperative gross malignancy of gallbladder were excluded from study.

Results In our study, females were predominating over males with a ratio of 6.07:1. The mean of all patients was 44.16±14.64 years. Chronic cholecystitis was most common (69.81%) histopathological entity. Incidental carcinoma was also revealed in 1.9 % of the cases. Metaplasia and xanthogranulomatous cholecystitis was reported in about 6% cases. Mixed stones were most common type reported in 76.79% cases. Multiple stones (72.8%) were more common than single stones. Majority (58%) of the cases in our study were operated by laparoscopic technique. Gallbladder perforation was most common complication noticed in about 4.15% cases.

Conclusions Despite meticulous preoperative investigations and gross specimen examination, incidental carcinoma of gallbladder is a rule rather than exception in significant number of cases. A routine histopathology of specimen should be considered especially in high risk zones of carcinoma gallbladder.