Incidence of Carcinoma in Gall Stone Disease and its Effect on People

Abstract

Background: Incidence of carcinoma of gallbladder is about 1% of cholecystectomy specimens sent to histopathologist for gall stone disease. Nowadays, in our institution it is routine, we are sending all gallbladder specimens for histopathology, for ruling out the incidental gallbladder carcinoma. Aim of our study is to assess the need of routine histopathology of all gallbladder specimens, in which cholecystectomy (laparoscopic / open) done because of gallstone disease.

Study Design: Retrospective study

Place and Duration of Study: This study was conducted in Surgical Department of Ghulam Muhammad Mahar Medical College Sukkur and Hira Medical Centre Sukkur with the time duration of nine years from 2004-2012.

Patients and Methods: This study containing all patients of gall stone disease had gone through cholecystectomy in the duration of nine years review of all patients in surgical departments of Shaheed Muhtarma Benazir Bhutto (Ghulam Muhammad Mahar Medical College Sukkur) and Hira medical centre sukkur. Hospital record of all patients was received, data, pre-operative image (ultrasound and computed tomography) finding, intra-operative, macroscopic appearance of specimen and histopathological reports were collected. Surgeon’s impression of thickened gall bladder and other gross examination findings were noted from operative notes along with gross histopathological reporting.

Results: Total of twelve hundred (1200), patients were gone through cholicystectomy for gallbladder stone disease. Carcinoma gallbladder was detected only in ten patients (0.833%) and macroscopic abnormalities were found in all 10 same patients. Patients on macroscopic examination found normal gallbladder, having no evidence of carcinoma gallbladder.

Conclusion: In all cases of cholecystectomy for gall bladder stone disease, gall bladder should be incised (opened) and examine in detail for macroscopic abnormalities. Histopathology selection should be recommended for those specimens, having gall bladder wall thickening above 3mm, mucosal ulceration, polypoidal lesion, nodularity of mucosa or preoperative suspicious  of malignancy. This selection policy will reduce the cost of patients and pathologist workload without compromising patient’s treatment