Cholecystectomies – A 1.5 year histopathological study

Background: The gallbladder is a surgically important organ of the body which may be affected by a variety of pathological processes, which are often, under appreciated. It has a wide spectrum of diseases ranging from congenital anomalies, gallstones and its complications, non-inflammatory, inflammatory to the neoplastic lesions. Gallbladder pathology is a frequent source of patient complaint, presenting as acute or chronic right upper quadrant pain, jaundice, or dyspepsia. Gallstones are the commonest pathology of biliary system causing morbidity and mortality. Absolute diagnosis of the premalignant and malignant lesions is possible only after histopathologic examination of the specimen, as pre-operative imaging techniques fail to identify the lesions. Aims and objectives: To study the histomorphology of various gall bladder lesions, to determine the age and sex distribution of the lesions and to ascertain the frequency of abnormalities. Materials and methods: This was a prospective study conducted at Gandhi Hospital, Hyderabad for a period of 1.5 years, i.e. from December 2014 to May 2016. A total of 170 cholecystectomies were received, (including both conventional and laparoscopic types of surgeries) from Department of General Surgery. After gross examination, representative bits were taken and submitted to routine processing, paraffin embedding, cutting and staining. Sections were stained with conventional hematoxylin and eosin and were analyzed. Results: In the present study, various types of lesions were identified and categorized as follows. Congenital anomaly (a single case of Duplication) was noted. Chronic cholecystitis (79), Chronic Cholecystitis with Cholelithiasis (59), Gangrene (13), Gangrene with perforation (3), Empyema (2), Xanthogranulomatous Cholecystitis (3), Adenomyosis (4), Follicular Cholecystitis (1), Cholesterolosis (1), Eosinophilic Cholecystitis (1), Porcelain gall bladder (1), Mucocele (1), and Carcinoma (1). Conclusion: Biliary disorders affect considerable portion of the population. 90% biliary diseases are attributed to cholecystitis. All cholecystectomies should be subjected to histopathological examination in order not to miss the spectrum of gall bladder lesions and their significance.