2022, Vol. 4, Issue 1, Part D

An increasing frequency of gallbladder carcinoma has been observed during the last decade. The aim of this study is to find the premalignant lesions as well as incidental carcinoma in gallbladder resected for lithiatic cholecystitis. We focused mainly to determine the value of routine histopathologic examination of the gallbladder specimen resected for lithiatic cholecystitis.

Method: Total number of 250 consecutive patients with lithiatic cholecystitis who admitted for cholecystectomy at Ali Abad Teaching Hospital were included in this study. Laparoscopic cholecystectomy has been performed in 226 patients (90.4% of cases) while open surgery was performed in 24 (9.6%) of the patients. All resected gall bladders were sent to department of Pathology at Kabul University of Medical Science.

Result: Over a period of 3 years 250 patients with symptomatic gallstone were admitted for cholecystectomy at Ali Abad Teaching Hospital. Of these 250 cases, 180 were female (72%) and 70 were male (28%).

Majority of patients were between the ages of 31- 50 year (75%). Most common pathology noted in our study was chronic cholecystitis in 90% of cases (n=230). The most common benign lesions were Cholesterolosis in 80% (n=200) of cases followed acute cholecystitis in 10% (n=25), porcelain gall bladder (n=3), xanthogranulomatous cholecystitis (n=3). Incidental carcinoma was found in 4 patients (1.6%). Precursor lesions such as Antral metaplasia found in 8 (3.2%), dysplasia in 3(1.2%).

Conclusion: Our study emphasize that cholecystectomy performed for a common condition like gallstone disease can result in a diverse and wide spectrum of histopathological lesions ranging from benign to unexpected gallbladder carcinoma. The histopathology spectrum of gall bladder is extremely variable. Incidental diagnosis of carcinoma of gall bladder is not rare. If protocol of routine histopathology of gall bladder specimen is not followed sub clinical malignancy would be missed to be identified with disastrous result. We recommended routine histopathology of all gallbladder specimen.