Incidence of carcinoma of gallbladder discovered on routine histopathology after cholecystectomy for cholelithiasis

ABSTRACT

This is a retrospective study of 148 patients, seeking for incidence of carcinoma of gallbladder in patients admitted with cholelithiasis in Surgical unit-3, Civil Hospital Karachi, form January 1999 to 2001, all of whom underwent cholecystecomy. Out of 148 patients, 120 [81%] were females [mean age 40 years], 14 [9.4%] were males [mean age 56 years]. The commonest clinical presentation was of upper abdominal pain [93%], followed by flatulent dyspepsia [65%], nausea and vomiting [25%], and palpable gallbladder [17%], jaundice [14%]. Live function tests were altered in 21% of cases, with raised alkaline phospatase in 17%. Utraonography of abdomen was done in all the patients, which showed choleithiasis in 100% of cases, increased wall thickness [7%], irregularity in the wall [4%], CBD dilatation with or without stones in 16% of cases. Laparoscopic Cholecystectomy was done in 72 patients and open cholecystectomy was done in 65 patients. 16 patients had CBD exploration. 08 patients were suspected of carcinoma gallbladder per-operatively. Cholecystectomy plus wedge resection of liver was done in 05 patients and the other 03 suspected cases had simple cholecystectomy. Histopathology of all the above patients revealed inflammatory changes in 138 patients [93%], 10 patients [7%] were diagnosed as stage-I carcinoma of gallbladder on histopathology. Of these 06 came bock for follow up, and no further surgical intervention was offered and treatment was expectant and symptomatic. The incidence of carcinoma discovered on routine histopathology after cholecystectomy for choleithiasis with chollecystitis was 7%