Summary:
Introduction: Carcinoma of the gallbladder is a malignancy
with very high mortality rate. Unfortunately, our common
practice to discard gallbladder specimens after
cholecystectomy in unsuspected malignancy. This results in
missing some premalignant conditions and early carcinomas.
This study was conducted to find out the incidence of
unsuspected gallbladder carcinoma from cholecystectomy
patients in routine histopathology of specimens and analyze
their clinico-pathological features.
Methods: This was a two years cross sectional study included
542 patients with acute or chronic cholecystitis secondary to
cholelithiasis operated by cholecystectomy. All cases of
carcinoma gallbladder, on clinical grounds or confirmed by
radiology were excluded. Gallbladders showing gross
abnormalities suggestive of localized or infiltrative
malignancy during surgery were also excluded. All
gallbladder specimens were send for histopathology
examination.
Results: Over a period of two years, five hundred and fortytwo
patients with symptomatic gallstones were admitted for
Journal of Bangladesh College of Physicians and Surgeons
Vol. 37, No. 4, October 2019
cholecystectomy. The male to female ratio was 1:3. Most of
the patients (26.49%) were found in fourth decade of life.
Majority of patients (93.54%) presented with upper
abdominal pain of varying duration. All the specimens were
sent for histopathology. Four hundred sixty cases (84.87%)
showed chronic cholecystitis (including intestinal metaplasia
and dysplasia). Seventy of the cases (12.92%) showed
evidence of acute cholecystitis (including empyema and
mucocele). Twelve gallbladders (2.21%) showed evidence
of adenocarcinoma of varying differentiation along with
cholelithiasis.
Conclusion: Incidental diagnosis of carcinoma gallbladder
is not rare. We strongly recommend to submit all
cholecystectomy specimens routinely to histopathology
laboratory, as this is the only means by which subclinical
malignancies can be detected at an early stage.
Key word: Gallstone, Unsuspected carcinoma, Routine
histopathology.
(J Bangladesh Coll Phys Surg 2019; 37: 186-190)
DOI: http://dx.doi.org/10.3329/jbcps.v37i4.43348