Title: Histopathological Study of Cholecystectomy Specimens in Tertiary Care Centre - Two Year Study
Authors: Dr Ashok Yadav, Dr Priyanka Solanki, Prof. Dr C.V.Kulkarni, Dr Vipin Todase
DOI: https://dx.doi.org/10.18535/jmscr/v5i5.89
Abstract
Background: Gallbladder stones are commonest disorder among gall bladder lesions and are usually asymptomatic. Its frequency in cholecystectomy specimens is not clear. The aim of this study is to report the morphological variants and frequency of different lesions in cholecystectomy specimens.
Material and Method: All cholecystectomy specimen received in 02 years duration in department of pathology, M.Y. Hospital, Indore. Total 106 cholecystectomy specimens were included in the study with age of patients varying from 18 years to 80 years. Detail clinical and other relevant history were taken followed by thorough gross examination and histopathological evaluation. Diagnosis was done by two different pathologists to rule out observer bias.
Result: Out of 106 cholecystectomy specimens studied, 99 (93.3 %) were inflammatory lesions , 05 (4.7%) were malignant and 01 case (0.9 %) was of benign neoplastic lesion. Among inflammatory lesions, 66 cases (62.2%) had gall stones, 24 cases (22.6%) were of chronic cholecystitis without cholelithiasis , 03 cases (2.8%) of acute cholecystitis. 03 cases(2.8%) of cholesterosis, and one case each of cholesterol polyp, pyocele, mucocele, and adenoma were found. Adenocarcinoma found in 05 cases (4.7 %), and one case included do not show any specific pathology.
Conclusion: Gall bladder lesions were common indication for surgical intervention and pathological evaluation. Most of them were inflammatory lesions with cholelithiasis, however thorough examination is important as these lesions may progress to fatal malignancies.
Keywords: Cholecystectomy, cholecystitis, adenocarcinoma.
References
1. Albores-Saavedra J, Menck HR, Scoazec JC, Soehendra N, Wittekind C, Sriram PV J, Spira B. Carcinoma of the gall bladder and extrahepatic bile ducts. In: Mamilton SR, Aaltonen LA, editors. WHO Classification of tumours. Pathology and genetics of tumours of the digestive system. Lyon: IARC Press; 2000. pp. 203–214.
2. Rosai J. Rosai and Ackerman’s Surgical Pathology. Ninth edition. Mosby; 2000. Gall bladder and extrahepatic bile ducts; pp. 1035–1060.
3. Fitzgerald JEF, Fitzgerald LA, Maxwell-Armstrong CA, Brooks AJ (2009). "Recurrent gallstone ileus: time to change our surgery?". Journal of Digestive Diseases 10 (2): 149–151. doi:10.1111/j.1751-2980.2009.00378.x. PMID 19426399.
4. Greenberger N.J., Paumgartner G (2012). Chapter 311. Diseases of the Gallbladder and Bile Ducts. In Longo D.L., Fauci A.S., Kasper D.L., Hauser S.L., Jameson J, Loscalzo J (Eds), 'Harrison's Principles of Internal Medicine, 18e.Retrieved November 08,2014fromhttp://accessmedicine.mhmedical.com.ucsf.idm.oclc.org/content.aspx?bookid=331&Sectionid=40727107.
5. Laurila JJ, Ala-Kokko TI, Laurila PA, Saarnio J, Koivukangas V, Syrjälä H, Karttunen TJ: Histopathology of acute acalculous cholecystitis in critically ill patients. Histopathology 2005;47:485-492.
6. Dr. Gudeli Vahini, Dr.Piddakala Premal-atha, Dr,Atchyutha Mathi, Dr. R.Krishna, Dr.I.V. Renuka. A Clinicopathological Study of Gallbladder Lesions. IOSR Journal of Dental and Medical Sciences (IOSR-JDMS)e-ISSN: 2279-0853,-ISSN: 2279-0861.Volume 14, Issue 2 Ver. III (Feb. 2015), PP 15-20 www.iosrjournals.org.
7. Pandey M, Pathak AK, Gautam A,Aryya NC,Shukla VK(2001).Carcinoma of the gallbladder:a retrospective review of 99 cases.Digest Dis and sci,46,1145-51.
8. Weedon D.Diseases of the gallbladder.In: MacSween RMN,Anthony PP ,Burt AD,et al,eds. Pathology of the liver ,third edition.New York :Churchill livingstone,1994:513-534
9. Jagannath SB,Singh VK,Cruz-Correa M,et al.A long term cohort study of outcome after cholecystectomy for chronic acalculous cholecystitis.Am J Surg 2003:185:91-95.
10. Bilhartz LE, Horton JD.Gall stone disease and its complications. In Feldman M, Sleisenger and Fordtran’s gastrointestinal and liver disease:pathophysiology /diagnosis/management,sixth ed.I Philadelphia:WB Sauders,1998:948-972.
11. Sjodahl R, Tagesson C.Wetterfors J.On the pathogenesis of acute cholecystitis a controlled clinical trial .Am J Surg 1976:146:199-202.
12. Edlund G,Ljungdahl M.Acute cholecystitis in the elderly.Am J Surg 1990;159;414-416.
13. T. R. Harrison; Harrisons’ Principles of Internal Medicine, volume 2, Ed. 17th, Part 13, Section II, Chapter 305, 1991 –2001.
14. Ref- N. T. Damor a, H. M. Chauhan*b and H. R. Jadav , Histological study of human gallbladder International Journal of Biomedical And Advance Research ISSN: 2229-3809 (Online) Journal DOI:10.7439/ijbar CODEN:IJBABN
15. Tadashi Terada Department of Pathology, Shizuoka City Shimizu Hospital, Shizuoka, Japan Received September 19, 2012; Accepted October 27, 2012; Epub November 20, 2012; Published January 1, 2013. Histopathologic features and frequency of gall bladder lesions in consecutive 540 cholecystectomies. Int J Clin Exp Pathol 2013;6(1):91-96 www.ijcep.com /ISSN:1936-2625/IJCEP1209013.
16. Dr. Gudeli Vahini, Dr. Piddakala Premalatha, Dr. Atchyutha Mathi, Dr. R. Krishna, Dr. I.V. Renuka A Clinicopathological Study of Gallbladder Lesions (June 2012-May 2013) IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 14, Issue 2 Ver. III (Feb. 2015), PP 15-20 www.iosrjournals.org.
17. M. E. Asuquo, M. S. Umoh, V. Nwabgbara, A. Inyang, C. Agbor; Cholecystectomy: Indication At University Of Calabar Teaching Hospital, Calabar, Nigeria; Annals Of African Medicine 2008; Vol.7(1): 35-37.
18. Om Tantia, Mayank Jain, Shashi Khanna, Bimalendu Sen; Incidental Carcinoma Gallbladder During Laparoscopic Cholecystectomy For Symptomatic Gallstone Disease; Surg Endosc. 2009; 23: 2041-2046.
19. Khanna Rahul, Chansuria Rashmi, Kumar Mohan et al. Histological changes in gallbladder due to stone disease; Indian Journal of Surgery 2006; 68:201-204.
20. George Bazoua, Numan humza, Taha lazim; Do we need histology for a normal looking gallbladder; J Hepatobiliary Pancreatic Surgery 2007; 14(6) :564-568.
21. Ojed V. J., Shilkin K. B., Walters M. N.; Premalignant epithelial lesions of the gallbladder : A Prospective Study of 120 Cholecystectomy Specimens; Pathology J 1985: 17(3):451-454.
22. R. Shrestha et al. Incidental Gallbladder Carcinoma: Value of Routine Histological Examination of Cholecystectomy Specimens; Nepal Medical College Journal 2010; 12(2): 90-94.
23. D Chattopadhyay, R Lochan, S Balupuri, BR Gopinath, KS Wyne; Outcome Of Gallbladder Polypoidal Lesions Detected By Transabdominal Scanning: A Nine Year Experience, World Journal Of Gastroenterology 2005; 11(14) : 2171-2173.