Authors : Cyrus Dara Jokhi, Sujata R Kanetkar, Nikita V Vohra
DOI : 10.18231/j.ijpo.2019.121
Volume : 6
Issue : 4
Year : 2019
Page No : 627-635
Introduction: Cholecystectomy is one of the most frequently performed emergency abdominal operation
as the gallstones are one of the major causes of morbidity and mortality all over the world affecting 10%
of adult population.
According to consolidated report of population based registries of India 2009-2011 (by National centre
for disease informatics and research), India has shown high incidence of gall bladder cancer in female
population of Kamrup (Assam) district, which is highest among the world.
Clinical diagnosis of the cholecystitis is made, based on history and physical examination along with
laboratory and radiological findings. However, histopathological study is the gold standard for the diagnosis
of cholecystitis. Histopathological examination many time reveals an unusual diagnosis bearing significant
implications on the treatment, prognosis and outcome of the patient.
Aim and Objectives: To study various lesions encountered in cholecystectomy specimens on
histopathology.
Observations and Results: The most common histopathological diagnosis was chronic cholecystitis seen
in 112 out of 130 cases (86.3%), followed by acute cholecystitis 12 cases (9.2%). There were 4 (3.0%)
cases of adenocarcinoma of gallbladder. Total 92.5% chronic cholecystitis cases were calculous while 66.6
% of acute cholecystitis and 25 % (one out of four) of gall bladder carcinoma were associated with gall
stones. Out of total 113 (86.9%) gallstones – 4 (3.5%) were pure cholesterol stones, 14(12.4%) pigmented
stones and 95 (84.1%) were mixed stones. In the present study all 4 cases (100%) of malignancy were
adenocarcinoma; out of which 1 case was (25%) papillary adenocarcinoma, 1 case (25%) was poorly
differentiated and 2 cases (50%) were moderately differentiated adenocarcinoma. Amongst the four cases
of adenocarcinoma, 3 (75 %) cases showed serosal infiltration and liver infiltration.
Conclusions: Clinical presentation of diseases of gall bladder is vague. Even malignancy of gallbladder
presents late in the course and with nonspecific symptoms, which can misguide the clinicians. Findings
of malignancy were subtle on radiological examinations also. Diagnosis of malignancy was made only by
histopathological examination (1.5% cases as incidental carcinoma).
Keywords: Ultrasonography, Adenocarcinoma, Incidental carcinoma, Cholecystitis.