Histopathological spectrum of gallstone disease from cholecystectomy specimen in rural areas of West Bengal, India- an approach of association between gallstone disease and gallbladder carcinoma

Abstract

Background: Gallstone disease (GSD) is a common health problem throughout the world and majority of this burden occurs in developing countries. Most of the gallbladder carcinoma (GBC) is associated with GSD but there is till deficit of information on this association. Beside this, there is no study on the spectrum of histopathological pattern of cholecystectomy specimens from GSD patients in rural areas of West Bengal of India. Methods: The study was carried out on GSD patients who were undergone for cholecystectomy at B.S. Medical College & Hospital of West Bengal over a period of three years from January 2013 to December 2015. Histopathological reports of cholecystectomy specimens were analyzed. Results: In the present study, total 786 GSD patients were included where 635 were female and 151 were male. Histopathological findings depicted that chronic cholecystitis was the most prevalent (79.8%) followed by acute-on-chronic cholecystitis (6.1%), cholesterolosis (2.9%) and xanthogranulomatous cholecystitis (1.7%) among the patients. Beside these, hyperplasia, metaplasia, dysplasia and GBC were observed in 2.0%, 4.7%, 2.2% and 0.6% of the patients respectively. The mean ages for patients with chronic cholecystitis, hyperplasia, metaplasia, dysplasia and carcinoma were 34.5, 37.2, 42.9, 43.9 and 53 years respectively. Study also showed that male GSD patients were more prone to pre-malignancy and malignancy (significant at 95% confidence limit). Conclusions: The study revealed that different types of histopathological features were present in the gallbladder of GSD patients where pre-malignant (hyperplasia, metaplasia and dysplasia) and malignant types were remarkable percentages though chronic cholecystitis was the commonest histopathological feature. Study also demonstrated that males with GSD were more prone to pre-malignancy and malignancy. Gradient ages may suggest that GBC was developed from cholecystitis to carcinoma via hyperplasia, metaplasia and dysplasia.