Vandana Pathak1, Sudha Pankaj Meena2, Deepti Sukheeja3, Naresh N. Rai4, Rakesh Kumar Singh5, Neelu Vashist6, Raj Shree Bhati
BACKGROUND
Gallstone diseases are a common surgical problem worldwide requiring cholecystectomy. They present with diverse clinical and
morphological spectrum. The aim of the study is to find out the morphological spectrum of gallstone disease in Hadoti region
of Rajasthan and to study the frequency of different pathological lesions in cholecystectomy specimens.
MATERIALS AND METHODS
A retrospective study was conducted over a time span of 26 months from January 2012 to February 2014. One thousand
cholecystectomy specimens with their clinical investigations and histopathological details were retrieved from our records.
Diverse histopathological changes were correlated with various parameters like age, sex, number, type of stones, wall thickness
and location of stones in gallbladder.
RESULTS
During the 26 months, 1000 cholecystectomy specimens were received, which represented 6.22% of total surgical specimens.
77% females and 23% males suffered from the disease with a sex ratio of 3.34:1. Maximum patients belonged to the age
segment of third and fourth decades (48.5%) with reducing or fewer incidences on either side of this age group. From 85.1%
of the cases, stones were extracted while 10.3% were acalculous. However, in 4.6% of cases stones were not received with
specimen. Most common histopathological finding was chronic cholecystitis accounting to 88.1%, acute cholecystitis 3.6%,
active chronic cholecystitis 2.5%, malignancy 2.3% and mucocele 1.3% incidences while other associated (dual) lesions like
ceroid granuloma, chronic eosinophilic cholecystitis, follicular cholecystitis, etc. represented a minute portion of all occurrences
(2.2%). 631 (63.1%) cases showed multiple stones of predominant mixed type. A total of 23 cases of incidental carcinoma
were seen.
CONCLUSION
The gallstone diseases in cholecystectomy specimens in Hadoti region showed a variety of benign lesions and malignant cases.
It also emphasised the importance of histopathology examination in routine for early detection of incidental carcinomas, which
accounted to a high incidence of 2.3%.
