Histomorphological Study of Acalculus and Calculus Gall Bladder in a Tertiary Care Hospital of Western Uttar Pradesh

Abstract

Introduction: Gall bladder is the most common surgically resected specimen as gallstones are one of the major causes of morbidity. There is increasing incidence of gall stones in India and more so in North India. It can be due to changes in life style such as fat rich food and sedentary life style. Stones can produce a wide variety of mucosal changes ranging from inflammatory, metaplastic, dysplastic and neoplastic lesions. Aim: This study was performed to find out the spectrum of histopathological lesions in gall bladder in cholecystectomy specimens with or without stones. Materials and Methods: This was a hospital based cross- sectional study conducted on 415 cholecystectomy specimens received between 1st November 2019 to 31st October 2020 in the department of Pathology of NCR Institute of Medical Sciences, Meerut. The specimens were received in 10% formalin, the gross details of specimens and stones were studied. Sections were taken from the representative areas, processed and stained with Haematoxylin and Eosin stain. These sections were studied meticulously. Demographic data was expressed as percentages. The p-value was calculated by chi-square test. Results: Of the 415 cholecystectomy specimens 337 were from females and 78 were from males with female to male ratio of 4.3:1. The most common histopathological finding was chronic cholecystitis followed by cholesterolosis observed in 206/231 (89.17%) and 28/31 (90.32%) respectively in gall bladders with stones and in 25/231 (10.82%) and 3/31 (9.36%) of gall bladders without stones. Metaplasia and dysplasia was found in 81/83 (97.59%) and 15/16 (93.75%) of cases with stones, and in 2/83 (2.40%) and 1/16 (6.25%) cases without stones. Conclusion: Cholelithiasis produces diverse mucosal alterations some of which are precancerous and can progress to cancer. So, histopathological examination of all the gall bladders is essential for the detection of premalignant and malignant conditions.