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Incidental CaGB in Operated Cases of Gallstone Disease
a tertiary care referral hospital in eastern Uttar Pradesh, India, Table 1: Intraoperative findings of our study group (N = 200)
on 200 consecutive patients who underwent cholecystectomy Operative finding Frequency % Valid % Cumulative %
(laparoscopic/open) for chronic cholecystitis between October 2014 Valid
and May 2016. An informed written consent was taken.
GB distended, 165 82.5 82.5 82.5
Inclusion Criteria adhesion-minimal
All patients who underwent cholecystectomy (laparoscopic/open) GB contracted, 21 10.5 10.5 93
for chronic cholecystitis. adhesion+
GB contracted, 9 4.5 4.5 97.5
Exclusion Criteria adhesion−
• Diagnosed or suspected case of CaGB. GB distended, 5 2.5 2.5 100
• Patients not fit for surgery. adhesion+
Parameters Studied Total 200 100.0 100.0
• Detailed history and clinical examination.
• Baseline investigative work up.
• Special investigations like prothrombin time (PT), USG
whole abdomen, CT scan abdomen, magnetic resonance
cholangiopancreatography—where indicated, endoscopic
retrograde cholangiopancreatography (ERCP)—where indicated.
• Histopathology.
Statistical Analysis
SPSS statistical software was used for analysis. One-way analysis
of variance test was used to compare between two groups. To test
the association between variables, Fisher’s exact test was used.
The P-value less than 0.05 was considered as significant. Results of
the study were compiled, tabulated, and analyzed using statistical
methods, and inference was drawn. All information recorded in
the proforma was verified. The results were compared with data
obtained from different geographical regions. A total of 200
consecutive chronic cholecystitis patients who satisfied the study
criteria were incorporated as the study group. This study was Fig. 1: Bar graph showing intraoperative findings of our study group
ethically conducted in accordance with Declaration of Helsinki. (N = 200)
results Table 2: Histopathology examination findings of our study group
Results and findings observed in studied sample are presented in (N = 200)
the subsequent sections. Histopathological
examination (HPE) Frequency % Valid % Cumulative %
Intraoperative Findings Valid
Intraoperative findings are depicted in Table 1 and Figure 1. In Chronic cholecystitis 195 97.5 97.5 97.5
most of the patients, gallbladder (GB) was distended, adhesion was Dysplasia bordering 1 0.5 0.5 98
minimal, and GB contained multiple or single stones. to adeno Ca in situ
Histopathology Findings Well-differentiated 1 0.5 0.5 98.5
Different biopsy findings are mentioned in Table 2 and Figure 2. adeno CaGB
(pT3NxMx)
According to the biopsy report, five cases were diagnosed as
CaGB, usually infiltrating up to lamina propria. Most of these were Moderately 1 0.5 0.5 99
differentiated adeno
adenocarcinoma. Rest were frank chronic cholecystitis. CaGB (pT3NxMx)
Final Diagnosis Poorly differentiated 1 0.5 0.5 99.5
Among 200 patients, 195 had chronic cholecystitis, and 5 cases adeno CaGB
were diagnosed as CaGB in the postoperative settings from their (pT2NxMx)
biopsy report (Table 3; Figure 3). These cases are incidental CaGB. Poorly differentiated 1 0.5 0.5 100
adeno CaGB
Comparative Results between Chronic Cholecystitis (pT3NxMx)
and Incidental CaGB Total 200 100.0 100.0
Demographic Profile
Age • Among chronic cholecystitis patients, mean age: 44.15 years,
• Among the incidental CaGB patients, mean age: 45.4 years; median: 44; mode: 45; standard deviation: 14.67; minimum age:
median age: 36 years; standard deviation: 18.64; mode: 30; 6 years; maximum age: 78 years (Tables 4 and 5).
minimum age: 30 years; maximum age: 76 years (Tables 4 and 5). • p = 0.85 (unpaired t-test)—not significant.

178 World Journal of Laparoscopic Surgery, Volume 14 Issue 3 (September–December 2021)