Publication:

Histopathological patterns of gall bladder diseases with special reference to incidental cases: a hospital based study

Background Cholecystectomy for gall bladder dieases is the most commonly performed surgical procedure world wide. Routine examination of the gall bladder after surgery throw up interesting possibilities including carcinoma. It is the endeavour of this study to quantify the various outcomes in a tertiary level hospital.

Methods A total of 348 cases of cholecystectomy specimens were studied to evaluate the histopathological patterns with special reference to incidental asymptomatic gall bladder diseases .The cases were investigated and surgically treated .The specimens were fixed in 10% formalin and sent to the department of Pathology GMCH from department of surgery. The age, sex and other hospital details were recorded from the month of May 2015 to August 2015.The specimens were examined grossly and processed routinely. Sections were stained with haematoxylin and eosin. The gross and microscopic findings examined and noted. The study was aimed at assessing the need for histopathological examination in all cholecystectomy specimens.

Results In our study out of 348 cases of which 92 cases were female and 256 cases were male. The Male: Female ratio was 1:2.8 in our study. Age distribution showed 10 patients were below 20 years, youngest was 11 years. Between 21-30 there were 80 patients, between 31-40 years 82 patients, between 41-50 years there were 83 patients, between 51-60 years 46 patients and above 60 years 47 patients. Nonneoplastic to neoplastic cases which is 1:115 and percentage of neoplastic cases is 0.86% in our study. Histomorphological variants of the 348 cases in our study showed that maximum cases were of chronic calculous cholecystits(300CASES) followed by chronic cholecystitis with evidence of cholesterosis(14 cases).3 cases of adenocarcinoma were detected out of which 2 cases were incidental adenocarcinoma of gall bladder. Out of the 348 cases studied, 30 cases were diagnosed with incidental gall bladder disease during routine investigation for pregnancy, ureteric colic, dysfunctional uterine bleeding and incisional hernia. Out of this 30 cases 5 patients were male and 25 patients were female (ratio 1:5).

Conclusions Our study strongly recommends routine histopathological examination of all cholecystectomy specimens for detection of various variants of chronic cholecystits and also of incidental Carcinoma of gall bladder which helps in their treatment and prognosis.