A retrospective study of post-operative gall bladder pathology with special reference to incidental carcinoma of the gall bladder

Jagannath Dev Sharma, Indrajit Kalita, Tonmoy Das, Papari Goswami, Manigreeva Krishnatreya

Abstract


Background:Surgical removal of gall bladder for its diseases is common. However, not much is known about the incidence of incidental carcinoma in such patients in our population. Objective of current study was to analyze the different pathological entities of post-operative gall bladder specimen with particular emphasis on incidental carcinoma.

Methods:This retrospective study was carried out at a multi-specialty hospital in eastern India from the pathology records for the period from August 2005 to July 2008. The records were analyzed for gender, age group distribution, and pathological types with different histology.

Results:Out of 863 records, chronic cholecystitis 51.2% was the most common histology and malignancy was seen in 2.7% (23/863) both pre-operative and post-operative diagnosis. In the neoplastic group incidental carcinoma was diagnosed in 1.9% (17/23) of cases

Conclusion:Histopathological examination of gallbladder specimen helps to identify non-neoplastic conditions with its complications and also, for the detection of incidental carcinoma. Thorough sampling of all gallbladder specimens is a must to detect focal neoplastic changes.


Keywords


Carcinoma gall bladder, Cholecystitis, Gall bladder pathology, Incidental carcinoma

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References


National Center for Disease Informatics and Research (NCDIR). Consolidated report of population based cancer registries of India 2009-2011. In: V. M. Katoch, eds. NCDIR Report. Bangalore: ICMR; 2013: 1-210.

Nandakumar A, Gupta PC, Gangadharan P, Visweswara RN, Parkin DM. Geographic pathology revisited: development of an atlas of cancer in India. Int J Cancer. 2005;116:740-54.

Kiran CS, Das P, Agarwal N, Gupta SD. Pathology of Gallbladder Carcinoma in India: an overview. Indian J Med Paediatr Oncol. 2007;28(Suppl 2):16-24.

Kapoor VK, Pradeep R, Haribhakti SP, Sikora SS, Kaushik SP. Early carcinoma of the gallbladder: an elusive disease. J Surg Oncol. 1996;62:284-7.

Misra MC, Guleria S. Management of cancer gallbladder found as a surprise on a resected gallbladder specimen. J Surg Oncol. 2006;93:690-8.

Kimura W, Nagai H, Kuroda A, Morioka Y. Clinicopathologic study of asymptomatic gallbladder carcinoma found at autopsy. Cancer. 1989;64:98-103.

Silk YN, Douglass HO, Nava Jr HR, Driscoll DL, Tartarian G. Carcinoma of the gallbladder. The Roswell Park experience. Ann Surg. 1989;210:751-7.

Paolucci V, Schaeff B, Schneider M, Gutt C. Tumor seeding following laparoscopy: international survey. World J Surg. 1999;23:989-97.

Khan MA, Khan RA, Siddiqui S, Maheshwari V. Occult carcinoma of gallbladder: incidence and role of simple cholecystectomy. J-K Practitioner. 2007;14:22-3.

Elian A. Occult gallbladder carcinoma. Tanta Med Sc J. 2007;2:58-64.

Deguara J, Borg CM, Laferia G. Incidental gallbladder carcinoma in the Maltese Archipelago. Malta Med J. 2003;15(Suppl 1):1728-9.

Weinstein D, Herbert M, Bendet N, Sandbank J, Halevy A. Incidental finding of gallbladder carcinoma. Israel Med Assoc J. 2002;5:334 -6.

Eugenio C, Cesare T, Giuseppinella M, Iapichino G, CurrĂ² G. Incidental gall bladder carcinoma: does the surgical approach influence the outcome? ANZ J Surg. 2005;75:795-8.

Sikora SS, Singh RK. Surgical strategies in patients with gallbladder cancer: nihilism to optimism. J Surg Oncol. 2006;93:670-81.

Dixit VK, Prakash A, Gupta A, Pandey M, Gautam A, Kumar M, et al. Xanthogranulomatous cholecystitis. Dig Dis Sci. 1998;43:940-42.

Kwon AH, Matsui Y, Uemura Y. Surgical procedures and histopathologic findings for patients with xanthogranulomatous cholecystitis. J Am Coll Surg. 2004;199:204-10.

Spinelli A, Schumacher G, Pascher A, Lopez-Hanninen E, Al-Abadi H, Benckert C, et al. Extended surgical resection for xanthogranulomatous cholecystitis mimicking advanced gallbladder carcinoma: a case report and review of literature. World J Gastroenterol. 2006;12:2293-6.

Shukla VK, Prakash A, Tripathi BD, Reddy DCS, Singh S. Biliary heavy metal concentrations in carcinoma of the gall bladder: case-control study. Br Med J. 1998;317:1288-9.