The Spectrum of Gallbladder Histopathology at a Tertiary Hospital in a Developing Country: A Retrospective Study

Almas, Talal; Murad, Muhammad Faisal; Khan, Muhammad Kashif; Ullah, Mujib; Nadeem, Faisal; Ehtesham, Maryam; Zaidi, Syed Muhammad Jawad

doi:10.7759/cureus.9627

Cited by 4 publications

(9 citation statements)

References 19 publications

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“…15 In the present study, the age of the patients ranged from 12 years to 78 years and average age of presentation was 43.13 years, whereas for malignant lesions it was 53 years. Maximum cases who underwent cholecystectomy for gallbladder diseases were seen in 4 th and 5 th decades of life (Table1), which was similar to study by Almas T et al 13 and Beena D et al 16 In the present study calculi were retrieved in only 348 cholecystectomy specimens out of the total 760 cases examined. In these 348 cases, mixed cholesterol/pure cholesterol stones were more common and seen in 87.36% of cases, whereas pigment stones were seen in 12.64% of cases (fig.…”

Section: Discussionsupporting

confidence: 88%

“…In the present study out of total 760 cases, 595 cases were obtained from the females, with a female to male ratio of 3.6:1, which was comparable to study by Almas T et al and Mushtaq M et al 13,14 Increased estrogen levels in females increase cholesterol excretion in the bile leading to its supersaturation, and hence a 2-3 times higher risk of gallstones in reproductive aged females as compared to their male counterparts. In pregnancy gallbladder evacuation function also suffers which further increase the risk of gallstone diseases, especially in multiparous females.…”

Section: Discussionsupporting

confidence: 84%

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Histomorphological spectrum of gallbladder lesions- A prospective study from a teaching hospital

Dabral,

Pant,

Rizvi

2023

J Pathol Nep

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Background: Prevalence of gallbladder diseases vary with socio-demographic factors and in India it is around 2-29%. Cholelithiasis causes varied histopathological changes in gallbladder mucosa like acute and chronic inflammation, cholesterolosis, hyperplasia, metaplasia, dysplasia and carcinoma. Gallbladder carcinomas often present as an incidental finding in cholecystectomy specimens. Present study was conducted to identify spectrum of histopathological lesions and to find the incidence of gallbladder carcinoma in cholecystectomy specimens received at tertiary care centre in North Indian state of Uttarakhand. Materials and Methods: A prospective study was conducted in the Department of Pathology, Government Medical College, Haldwani from January 2021 to September 2022. Total 760 cholecystectomy specimens were received during the study duration. Grossing of gallbladder specimens was done as per Gallbladder Carcinoma (GBC) expert consensus statements. Results: Out of 760 cholecystectomy specimens, 595 cases (78.29%) were obtained from females, with a female to male ratio of 3.6:1. Maximum cases were seen in 4th and 5th decades of life. Chronic cholecystitis was the most common histopathological diagnosis [709 cases (93.28%)], followed by acute cholecystitis in 20 (2.63%), follicular cholecystitis in 14 (1.84%) cases, 02 (0.26%) each of xanthogranulomatous cholecystitis and porcelain gallbladder, 05 cases (0.66%) of high-grade dysplasia and 08 cases (1.05%) of gallbladder adenocarcinoma. Out of 08 cases of gallbladder carcinoma, six were incidental diagnoses. Conclusions: Histopathological evaluation of all resected cholecystectomy specimens is imperative for the detection of premalignant and malignant lesions that might escape in gross and radiological examination and thus could adversely affect patient outcome.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionsupporting

confidence: 84%

Histomorphological spectrum of gallbladder lesions- A prospective study from a teaching hospital

Dabral,

Pant,

Rizvi

2023

J Pathol Nep

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“…This is in contrast to a study done in Pakistan, which found a greater percentage of 32.8% of people had this condition. 13 The histopathology revealed lipid laden macrophages along with villous hypertrophy causing yellowish streaks.…”

Section: Discussionmentioning

confidence: 99%

A retrospective single centre study on histopathological analysis of cholecystectomy specimens in a tertiary care centre in India

Degloorkar,

Parab,

Shah

et al. 2023

Int Surg J

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Background: Gall bladder carcinoma is the 5th most common gastrointestinal malignancy which has a poor 5-year survival rate, carrying dismal prognosis. Diagnosing chronic cholecystitis from gall bladder cancer is challenging. Early detection of gall bladder carcinoma allows for the possibility of radical resection surgery, which has been shown to increase patient survival. Methods: A retrospective histopathological analysis was conducted at a tertiary care centre to evaluate the incidence of gall bladder carcinoma. A total of 1728 cholecystectomy samples were evaluated from all age groups for a period of 6 years. Results: Chronic cholecystitis was the most common impression on histopathological analysis, showing females have high predominance of developing gall bladder disease including malignancy. The incidence of gall bladder carcinoma was found to be 0.46 % with 8 cases of adenocarcinoma diagnosed, which were not diagnosed preoperatively. Conclusions: If missed, gall bladder cancer can progress rapidly and has a significant fatality risk if it is not detected in time. We conclude that all histopathology specimens be sent for routine analysis, to rule out gall bladder cancer, which if resected early can improve the survival of the patients.

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“…It is usually 1 to 9% symptomatic adenomyomatosis; in these cases cholecystectomy is indicated. It presents with abdominal pain [ 14 ]. In this study, patients who presented had symptoms of chronic cholecystitis and after histopathology report revealed adenomyomatosis.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Empyema or Mucocele or Other Histological Diagnoses in Patients Undergoing Cholecystectomy With Diagnosis of Chronic Cholecystitis

Khomusi¹,

Parveen²,

Iqbal³

et al. 2022

Cureus

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Background Chronic cholecystitis is inflammation of the gall bladder usually caused by stones. The aim was to find out the prevalence of mucocele and empyema in chronic cholecystitis using cholecystectomy findings and histopathological reports. Methodology This was a cross-sectional observational study conducted in Surgical Ward 1, Jinnah Postgraduate Medical Center, Karachi from December 2019 to December 2021 for two years. Patients above 12 years of age diagnosed with chronic cholecystitis with cholelithiasis on clinical examination and investigations were included. Patients who were diagnosed with acute cholecystitis, mucocele, or empyema on clinical examination and ultrasonography were excluded from the study. Laparoscopic cholecystectomy was done and operative findings were noted. Gall bladder specimens were examined for mucocele and empyema and were sent for histopathology. Results were recorded and analyzed. Results There were 241 patients diagnosed with chronic cholecystitis with cholelithiasis on clinical examination and investigations. On examination, tenderness in the right hypochondrium was absent in all patients. Chronic cholecystitis was proved on histopathology in 231 patients (95.85%). Other findings diagnosed on peroperative findings and histopathology reports were strawberry gall bladder (2.41%), empyema (0.83%), mucocele (0.41%), and polyp (0.41%). Two hundred eight patients were female (86.31%), 33 were male(13.69%). The male to female ratio was 1:6.43. The average age was 31 years. Conclusion Inflammation and fibrosis of the gallbladder around Calot’s triangle increase the chances of vascular and common bile duct injury. In such cases, cholecystectomy can become difficult. It was concluded that empyema, mucocele, and strawberry gall bladder could be found in chronic cholecystitis, and cholecystectomy becomes difficult in such cases.

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The Spectrum of Gallbladder Histopathology at a Tertiary Hospital in a Developing Country: A Retrospective Study

Cited by 4 publications

References 19 publications

Histomorphological spectrum of gallbladder lesions- A prospective study from a teaching hospital

Histomorphological spectrum of gallbladder lesions- A prospective study from a teaching hospital

A retrospective single centre study on histopathological analysis of cholecystectomy specimens in a tertiary care centre in India

Prevalence of Empyema or Mucocele or Other Histological Diagnoses in Patients Undergoing Cholecystectomy With Diagnosis of Chronic Cholecystitis

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