Incidental Gall Bladder Malignancy after Elective Cholecystectomy- A hospital-based study

Abstract

Objectives: This study was to evaluate the clinical incidental of gall bladder malignancy and its risk factors in various age group patients after elective cholecystectomy. Methods: Stages of malignancy was diagnosed according to the Eight Edition of AJCC TNM Manual. A total of 954 patients of gall bladder stone were enrolled in this study, among them 18(1.88%) patients were diagnosed with gall bladder malignancy on histopathological examinations. Results: Most of the patients 14(77.78%) were in age group of greater than 50 years and duration of symptoms was >40 weeks. Intraoperative findings in majorities of patients had 9(50%) shrunken fibrosed gall bladder with stones (chronic cholecystitis), 5(27.78%) polyploid mass, 3(16.67%) difficult cholecystectomy and 1(5.56%) thickened wall. on histopathological examination of specimens confirms that the majority of the patients 7(38.88%) had (Tis) carcinoma in situ, 4(22.22%) T1a, and 3(16.67%) T 2a and T2b. Conclusions: Gall bladder malignancy was commonly seen in lower middle socioeconomic class old age female patients. Due to nonspecific clinical and sonographic features,diagnosis of incidental gall bladder malignancies are usually missed. Chronic inflammation, cholelithiasis and adenomyomatosis are the major risk factors. Histopathological examination of the specimen is ensured so as to diagnose and treat life threatening incidental gall bladder malignancy. Performing cholecystectomy should never be the only treatment of gall stones or any other pathology unless and until histopathological examinations of specimens ensures to diagnose gall bladder malignancies.