Clinico-morphological features of incidental gall bladder carcinoma in laparoscopic cholecystectomy for gall stones at Rehman Medical Institute from 2017-2018

Abstract

Introduction: Gall bladder carcinoma is a highly malignant tumor with a poor prognosis and a survival rate of less than 10%; gall stones are reported as the major cause. Absence of specific symptoms results in missed diagnosis in early stages.

Objective: To determine the clinical and morphological features of gall bladder carcinoma found incidentally in specimens of laparoscopic cholecystectomy for gall stones at a tertiary care hospital of Peshawar, Khyber Pakhtunkhwa, Pakistan.

Methods: Data of 130 patients undergoing laparoscopic cholecystectomy for gall stones during 2017-18 were retrieved from the database of Department of Surgery, Rehman Medical Institute, Peshawar on a structured Performa, that included demographic data, clinical features, macroscopic features, and microscopic findings. Data were analyzed by SPSS 25 for descriptive statistics.

Results: Of 130 gall stones cases during 2017-18, females (65.4%) were almost double than males (34.6%). Most common complaint of patients was abdominal pain (88%) followed by weight loss (6%), fever (4%) and jaundice (2%). Incidence of malignancy in this study was 1.6%. Macroscopic features showed that gall stones associated with ulcers and wall thickening (76.1%) were common compared to simple wall thickening (23.8%).

Conclusion: Spectrum of malignancy is a rare and incidental finding in patients undergoing laparoscopic cholecystectomy for gall stones, probably because stages 1 and 2 are asymptomatic and may not be detected by routine ultrasound.

Keywords: Gall stones, Gall bladder, Gall bladder malignancy.