Study of histopathological findings in gallbladder diseases

Abstract

Introduction: Cholecystectomy is one of the most frequently performed emergency abdominal operation as the gallstones are one of the major causes of morbidity and mortality all over the world affecting 10% of adult population. According to consolidated report of population based registries of India 2009-2011 (by National centre for disease informatics and research), India has shown high incidence of gall bladder cancer in female population of Kamrup (Assam) district, which is highest among the world. Clinical diagnosis of the cholecystitis is made, based on history and physical examination along with laboratory and radiological findings. However, histopathological study is the gold standard for the diagnosis of cholecystitis. Histopathological examination many time reveals an unusual diagnosis bearing significant implications on the treatment, prognosis and outcome of the patient. Aim and Objectives: To study various lesions encountered in cholecystectomy specimens on histopathology. Observations and Results: The most common histopathological diagnosis was chronic cholecystitis seen in 112 out of 130 cases (86.3%), followed by acute cholecystitis 12 cases (9.2%). There were 4 (3.0%) cases of adenocarcinoma of gallbladder. Total 92.5% chronic cholecystitis cases were calculous while 66.6 % of acute cholecystitis and 25 % (one out of four) of gall bladder carcinoma were associated with gall stones. Out of total 113 (86.9%) gallstones – 4 (3.5%) were pure cholesterol stones, 14(12.4%) pigmented stones and 95 (84.1%) were mixed stones. In the present study all 4 cases (100%) of malignancy were adenocarcinoma; out of which 1 case was (25%) papillary adenocarcinoma, 1 case (25%) was poorly differentiated and 2 cases (50%) were moderately differentiated adenocarcinoma. Amongst the four cases of adenocarcinoma, 3 (75 %) cases showed serosal infiltration and liver infiltration. Conclusions: Clinical presentation of diseases of gall bladder is vague. Even malignancy of gall