Incidental Gallbladder Carcinoma: An Eastern Indian Experience and Necessity of Routine Histopathological Examination after All Cholecystectomy

Abstract

Introduction: The carcinoma of gallbladder is the most common malignancy of the biliary tract. The incidence of this carcinoma varies geographically. Incidental gallbladder carcinoma is diagnosed during histopathological examination after cholecystectomy due to other reasons. Histopathological examination of all cholecystectomy specimens are very essential to rule out these incidental gallbladder carcinomas. Aim: To this study to estimate the frequency of incidental gallbladder carcinoma in patients undergoing routine cholecystectomy and also to evaluate the necessity of routine histopathological examination after all cholecystectomy. Materials and Methods: A retrospective observational study was conducted in Department of Pathology, Midnapore Medical College and Hospital, West Bengal, India between January 2014 to December 2019 (six years) covering 650 patients who underwent laparoscopic and open cholecystectomy. Patients' demographic data, pathologic results, macroscopic appearance of the specimen, cancer staging were recorded and frequency of incidental gallbladder carcinoma were calculated. Result: Total 650 cholecystectomy specimens due to benign gallbladder disease were received in pathology department. Histopathological examination revealed 18 cases of incidental gallbladder carcinoma which comprised 2.8% of all the cholecystectomies. Among them 13 were female and five were in male with male: female ratio of 1:2.6 and the age ranges from 35 to 68 years. Among 18 cases 10 cases showed invasion upto lamina propria (stage T1a), five) cases had invasion in muscular layer (stage T1b) and three cases showed perimuscular connective tissue invasion (stage T2a). Conclution: The present study observed that the incidence of incidental gallbladder carcinoma in cholecystectomy specimen was little higher range in East Indian population and so routine histopathological examination of all cholecystectomy specimens are recommended.