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ORIGINAL RESEARCH
Study of Incidental Carcinoma Gallbladder in Operated Cases

of Gallstone Disease at Tertiary Care Hospital in Eastern Uttar

Pradesh

1
2
3
Vibhor Jain , Rishu Yogesh Mishra , Megha Gupta , Rahul Omprakash Paliwal 4
AbstrAct
Background and objectives: Due to the late detection of primary carcinoma of gallbladder (CaGB), the overall prognosis has remained poor with
a 5-year survival of 5–10%. In practice, after elective cholecystectomy for presumably benign gallbladder disease, primary CaGB is an unexpected
histopathological finding in resected specimens. Current study aims to determine the incidence of incidental CaGB and to determine factors
predictive of CaGB in patients operated for chronic cholecystitis.
Materials and methods: In this single center, prospective observational study, analysis of incidence and various biological characteristics of 200
consecutive patients with chronic cholecystitis was done who underwent cholecystectomy and were subsequently histologically diagnosed as
incidental CaGB. Results of the study were compiled, tabulated, and analyzed using statistical methods, and inference was drawn.
Results: In the study, five patients were diagnosed with incidental CaGB histologically after cholecystectomy for chronic cholecystitis, and
the incidence of incidental CaGB was 2.5%. Sociodemographic parameters and pathophysiological observations are additionally drawn to
determine factors predictive of primary CaGB.
Conclusions: In view of the study findings, it may be inferred that chronic cholecystitis is a significant surgical disease in our population. This
is significant because laparoscopic cholecystectomy is being more commonly used for the treatment of chronic cholecystitis in which there
are considerable chances of perioperative spillage of biliary contents because of which there are possibilities for the very early gallbladder
carcinoma becoming a disseminated disease. The operating surgeon should have high index of suspicion regarding this incidental but fatal
gastrointestinal malignancy.
Keywords: Carcinoma, Cholecystectomy, Gallbladder, Incidental, Laparoscopic.
World Journal of Laparoscopic Surgery (2021): 10.5005/jp-journals-10033-1475

IntroductIon 1 Department of Surgery, Autonomous State Medical College,
Gallbladder cancer is the most common malignant tumor of Shahjahanpur, Uttar Pradesh, India
the biliary tract worldwide and the fifth most common cancer 2 Department of Pharmacology, Autonomous State Medical College,
1,2
involving the gastrointestinal (GI) tract. Primary carcinoma of Shahjahanpur, Uttar Pradesh, India
gallbladder (CaGB) clinically resembles benign disease because 3 Department of Obstetrics and Gynecology, Varun Arjun Medical
of which it is detected late in its course. In practice, after elective College, Shahjahanpur, Uttar Pradesh, India
cholecystectomy for presumably benign gallbladder disease, 4 Department of Human Anatomy, Autonomous State Medical College,
primary CaGB is an unexpected histopathological finding in Shahjahanpur, Uttar Pradesh, India
1–3% resected specimens. It is prevalent mainly in sixth and Corresponding Author: Rahul Omprakash Paliwal, Department of
seventh decades of life. The overall prognosis has remained poor Human Anatomy, Autonomous State Medical College, Shahjahanpur,
because of the late detection of the disease with a 5-year survival Uttar Pradesh, India, Phone: 9021466258, e-mail: drpali91@gmail.com
of 5–10%. Before the era of computed tomography (CT) scan and How to cite this article: Jain V, Mishra RY, Gupta M, et al. Study of
ultrasonography (USG), the rate of correct preoperative diagnosis Incidental Carcinoma Gallbladder in Operated Cases of Gallstone
was only 8.6%, which has improved considerably with the use of Disease at Tertiary Care Hospital in Eastern Uttar Pradesh. World J Lap
newer imaging techniques. Still a preoperative diagnosis of early Surg 2021;14(3):177–182.
gallbladder carcinoma (EGBC) is rarely made, where the 5-year Source of support: Nil
survival is 91–100%. Most of the available literature is reported from Conflict of interest: None
developed countries, which have a different socioeconomic culture
and health setup from that of a developing country such as India. 1,2
The purpose of undertaking this study was that a reasonably incidence and various biological characteristics of patients of
high number of CaGB patients have been noted in the Gangetic gallstone disease who underwent cholecystectomy and were
planes of Uttar Pradesh, which forms the area of our study. We subsequently histologically diagnosed as incidental CaGB.
have undertaken a study of the incidence of CaGB in operated
cases of gallstone disease, which included all cases who underwent
cholecystectomy (laparoscopic/open) at Department of Surgery MAterIAls And Methods
in a tertiary care referral hospital in eastern Uttar Pradesh, India, The study comprised a single center, prospective observational
on consecutive 200 patients. The study involves the analysis of study. This study was conducted at Department of Surgery in

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