Frequency of Gall Bladder Carcinoma after Cholecystectomy for Symptomatic Gallstone Disease in Tertiary Care Hospital, Peshawar

Zia Ullah; Ahmad Arsalan Tahir; Muhammad Tayyab; Muhammad Ishfaq; Sabeen Nasir; Rubab Naseer

doi:10.51253/pafmj.v73i6.8549

Authors

Zia Ullah Department of General Surgery, Peshawar Medical College, Peshawar Pakistan
Ahmad Arsalan Tahir Department of General Surgery, Peshawar Medical College, Peshawar Pakistan
Muhammad Tayyab Department of General Surgery, Peshawar Medical College, Peshawar Pakistan
Muhammad Ishfaq Department of General Surgery, Peshawar Medical College, Peshawar Pakistan
Sabeen Nasir Department of Pathology, Peshawar Medical College, Peshawar Pakistan
Rubab Naseer Department of Gynae & Obs, Peshawar Medical College, Peshawar Pakistan

DOI:

https://doi.org/10.51253/pafmj.v73i6.8549

Keywords:

Cholecystectomy, Cholelithiasis, Gall bladder neoplasms, Pathology

Abstract

Objective: To determine the frequency of gall bladder carcinoma after cholecystectomy for symptomatic gallstone disease and to determine the most commonly affected age group and its gender-based predominance in our population.

Study Design: Cross sectional study.

Place and Duration of Study: Histopathology Lab, Tertiary Care Teaching Hospital, Peshawar Pakistan, from Jan 2015 to Jan
2021.

Methodology: A total of 995 patients of all age groups and of either gender were included in our study. The demographics, clinical data of the patient (signs, symptoms and ultrasound report), and histopathology findings were recorded.

Results: The mean age of our study participants was 41.5±15 years. Cholecystitis was found in 807(81.1%) patients, acute
cholecystitis in 101(10.2%) patients, and chronic cholecystitis with cholesterols in 72(7.2%) patients. Benign polyps were found in 6(0.6%) patients, while carcinoma gall bladder was found in 9(0.9%) patients. The frequency of gall bladder carcinoma was high in females (n=774, 66.7%). The most commonly affected age group affected by gall bladder carcinoma was 51 to 60 years.

Conclusion: Routine histopathology of all grossly looking normal gall bladder specimens after cholecystectomy should be
done as it is the only measure to detect carcinoma gall bladder at early stages.

Downloads

Download data is not yet available.

References

Sarawagi R, Sundar S, Raghuvanshi S, Gupta SK, Jayaraman G.Common and uncommon anatomical variants of intrahepaticbile ducts in magnetic resonance cholangiopancreatography andits clinical implication. Pol J Radiol 2016; 81(1): 250-254.https://doi.org/10.12659/pjr.895827

Kapoor T, Wrenn SM, Callas PW, Abu-Jaish W. Cost analysisand supply utilization of laparoscopic cholecystectomy. Minim

Invasive Surg 2018; 2018(1): 7838103. https://doi.org/10.1155/2018/7838103

Blythe J, Herrmann E, Faust D, Falk S, Edwards-Lehr T,Stockhausen F, et al. Acute cholecystitis–a cohort study in a realworld clinical setting (REWO study, NCT02796443). PragmatObs Res 2018: 9: 69-75. https://doi.org/10.2147/por.s169255

Strasberg SM. Tokyo guidelines for the diagnosis of acutecholecystitis. J Am Coll Surgeons 2018; 227(6): 624-627.

Gupta K, Faiz A, Thakral RK, Mohan A, Sharma VK. Thespectrum of histopathological lesions in gallbladder in cholecystectomy specimens. Int J Clin Diagnostic Pathol 2019; 2(1):146-151. https://doi.org/10.33545/pathol.2019.v2.i1c.22

Bains L, Maranna H, Lal P, Kori R, Kaur D. The giant resectablecarcinoma of gall bladder—a case report. BMC Surg 2021; 21(1):133. https://doi.org/10.1186%2Fs12893-021-01117-2

Alkhayyat M, Abou Saleh M, Qapaja T, Abureesh M, AlmomaniA, Mansoor E, et al. Epidemiology of gallbladder cancer in theUnites States: a population-based study. Chin Clin Oncol 2021;10(3): 25-28. https://doi.org/10.21037/cco-20-230

Nagino M, Hirano S, Yoshitomi H, Aoki T, Uesaka K, Unno M, etal. Clinical practice guidelines for the management of biliarytract cancers 2019: The 3rd English edition. J HepatoBiliaryPancreat Sci 2021; 28(1): 26-54. https://doi.org/10.1002/jhbp.870

Baseer M, Ali R, Ayub M. The frequency of incidental gallbladder carcinoma after laparoscopic cholecystectomy for

chronic cholecystitis with gall stones. Ann Punjab Med Coll 2019;13(2): 130-132. https://doi.org/10.29054/apmc/2019.69

Kotasthane VD, Kotasthane DS. Histopathological spectrum ofgall bladder diseases in cholecystectomy specimens at a ruraltertiary hospital of Purvanchal in North India-does it differ fromSouth India. Arch Cytol Histopathol Res 2020; 5(1): 91-95.https://doi.org/10.18231/j.achr.2020.018

Kose S, Grice K, Orsi W, Ballal M, Coolen M. Metagenomics ofpigmented and cholesterol gallstones: the putative role of

bacteria. Sci Rep 2018; 8(1): 1-13.https://doi.org/10.1038/s41598-018-29571-8

Matsumoto T, Seno H. Updated trends in gallbladder and otherbiliary tract cancers worldwide. Clin Gastroenterol Hepatol 2018;16(3): 339-340. https://doi.org/10.1016/j.cgh.2017.11.034

Sikora SS, Singh RK. Surgical strategies in patients withgallbladder cancer: nihilism to optimism. J Surg Oncol 2006;

(8): 670-681. https://doi.org/10.1002/jso.20535

Siddiqui FG, Memon AA, Abro AH, Sasoli NA. Routinehistopathology of gallbladder after elective cholecy-stectomy for

gallstones: waste of resources or a justified act? BMC Surg 2013;13(1): 1-5. https://doi.org/10.1186/1471-2482-13-26

Samad A. Gall bladder carcinoma in patients undergoingcholecystectomy for cholelithiasis. J Pak Med Ass 2005; 55(11):497-499.

Siddiqui FG. An audit of cholecystectomy specimens. J Surg Pak2002; 7(2): 18-21. https://doi.org/10.1186/1471-2482-13-26

Ayyaz M, Waris M, Fahim F. Presentation and Etiological Factorsof Cancer Gall Bladder in Patients undergoing Cholecystectomies at Mayo Hospital, Lahore. Ann King Edward MedUni 2001; 7(2). https://doi.org/10.21649/akemu.v7i2.1830

Nawaz T. Incidence of carcinoma gall bladder in cholelithiasis.Pak J Surg 2000; 16(3-4): 33-36.

Alvi AR, Siddiqui NA, Zafar H. Risk factors of gallbladdercancer in Karachi-a case-control study. World J Surg Oncol 2011 ;

: 164. https://doi.org/10.1186/1477-7819-9-164.

Bazoua G, Hamza N, Lazim T. Do we need histology for anormal‐looking gallbladder? J Hepatobiliary Pancreat Surg 2007;

(6): 564-568. https://doi.org/10.1007/s00534-007-1225-6

Mittal R, Jesudason MR, Nayak S. Selective histopathology incholecystectomy for gallstone disease. Indian J Gastroenterol2010; 29(1): 32-36. https://doi.org/10.1007/s12664-010-0005-4

Beena D, Shetty J, Jose V. Histopathological spectrum of diseasesin gallbladder. Natl J Lab Med 2017; 6(1): 6-9.

https://doi.org/10.7860/NJLM/2017/23327:2245

Aslam V, Hussain S, Rahman S, Khan SM, Jan WA. Frequency ofcarcinoma in post‐cholecystectomy biopsy specimens of gallbladder. Pak J Med Health Sci 2015; 9(1): 1350-1352.