Incidence of Incidental Gallbladder Carcinoma in Cholecystectomy Patients: A retrospective analysis from a Tertiary Care Center in Northern India

Abstract

Gallbladder diseases, particularly those involving gallstones, are a widespread health issue globally. Cholecystectomy, often performed to manage gallstone-related conditions, can occasionally reveal incidental gallbladder carcinoma (IGBC) during histopathological evaluation. Identifying the incidence and characteristics of IGBC is critical for enhancing patient outcomes and clinical strategies.
Objectives
This study aimed to assess the frequency, clinical features, and pathological characteristics of IGBC in patients undergoing cholecystectomy at a tertiary care center in northern India.
Materials and methods
The retrospective study analysed 847 consecutive gallbladder specimens received from patients who underwent cholecystectomy over a period of two years. All cholecystectomy specimens during the study period were included, except patients with preoperatively suspected carcinoma and poorly preserved or inadequate specimens. Histopathological examination was performed using Hematoxylin and Eosin staining, and tumour staging was carried out according to the American Joint Committee on Cancer (AJCC) guidelines. Patient demographics, clinical presentation, imaging findings, and histopathological features were also reviewed.
Results
Among the 847 specimens, IGBC was detected in 8 patients (0.94%), all in females, with a mean age of 52.38 years. Most presented with right upper quadrant pain (75%). Ultrasonography commonly showed gallstones (87.5%) and thickened gallbladder walls (75%). Histologically, 7 patients were adenocarcinomas, and 1 was lymphoepithelioma-like carcinoma. Pathological staging revealed 3 patients at pT1, 4 at pT2, and 1 at pT3.
Conclusion
The study highlights an IGBC incidence of 0.94%, emphasizing the need for routine histopathological analysis of gallbladder specimens. This practice aids in detecting early-stage carcinomas, which can significantly improve survival rates and guide appropriate management strategies.