Missed gall bladder malignancy: A result of ignoring predisposing factors

Abstract

The underestimation of the prevalence of gallbladder carcinoma, which constitutes a predominant form of malignant neoplasm affecting the biliary tract, poses a significant threat due to its asymptomatic progression. Therefore, this study aimed to analyse the clinical, imaging, and intraoperative outcomes in cases of gallbladder carcinoma. This retrospective investigation was conducted from September 2022 to March 2023 at the Department of General Surgery of FH Medical College. A total of 153 patients deemed suitable for surgery participated in this study and underwent the relevant procedures. Various diagnostic and laboratory tests were administered to the patients, including blood analysis, random blood sugar determination, viral markers, chest X-ray, renal and hepatic functional tests, and comprehensive abdominal ultrasound. Gallbladder specimens were subjected to histopathological examination, and the results were documented and analysed. In histopathological reports, signs of precancerous lesions were noted in 30 out of 153 patients who underwent surgical treatment. The frequency of the disease was higher among women. Among these 30 patients, 22 had ultrasound-diagnosed gallstone disease with acute or chronic cholecystitis, while 8 patients had gallstone disease without gallbladder wall thickening. Additionally, 9 of these patients exhibited focal/irregular/thickening of the wall ≥10 mm. Overall, 16 patients showed elevated liver function, and 4 had an increased glucose level among those with histopathological evidence of precancerous lesions. This study underscores the elusive nature of gallbladder cancer, emphasizing the necessity for a comprehensive assessment, meticulous preoperative evaluation, and a multidisciplinary approach to facilitate early detection and treatment