Title: Evaluation on Incidental Gallbladder Carcinoma in Eastern India: A Hospital Based Study

Authors: Dr Swodeep Mohanty MS FMAS, FAIS, Dr Tapan Kumar Mohapatra, Dr Krupa Sindhu Panda

 DOI:  https://dx.doi.org/10.18535/jmscr/v4i12.130

Abstract

GBC is the most common cancer of the biliary tract Worldwide. Cholecystectomy is one of the most common abdominal surgeries. Gallbladder malignancy is a lethal disease and is the fifth commonest malignancy in the gastrointestinal tract. A detailed clinical history and thorough physical examination was done in all cases. Routine ultrasonography and blood investigations were done. Both open and laparoscopic techniques were used in surgery. GBC is not an uncommon clinical entity in our Indian scenario, unlike western countries. It is predominantly a disease of females. Incidental gallbladder carcinoma is a nightmare for patients after cholecystectomy. Despite careful preoperative investigations and meticulous gross examination, a significant number of incidental carcinoma cases are still missed.

Keywords:  Gallstone, Carcinoma and Cholecystectomy.

References

1.      Murshid KR. Asymptomatic gallstones: Should we operate? Saudi J Gastroenterol 2007; 13: 57-69.

2.      Scott HS. The gallbladder and extrahepatic biliary tree. In: Stacey EM, Darryl C, Joel KG, Harold AB, Victor ER, Mark HS. Sternberg’s Diagnostic surgical pathology. 4th ed. Philadelphia: Lippincott Williams & Wilkins; 2004. p. 1783.

3.      Stinton LM, Shaffer EA. Epidemiology of gallbladder disease: Cholelithiasis and Cancer. Gut and Liver. 2012;6(2):172-87.

4.      Mohan H, Punia RPS, Dhawan SB, Ahal S and Sekhon MS. Morphological spectrum of gallstones disease in 1100 cholecystectomies in north India. Indian J Surg. 2005;67:140-2.

5.      Awasthi N. A retrospective histopathol-ogical study of cholecystectomies. Int J Health Allied Sci. 2015;4:203-6.

6.      Khuroo MS, Mahajan R, Zargar SA, Javid G and Sapru S. Prevalence of biliary tract disease in India: a sonographic study in adult population in Kashmir. Gut. 1989;30:201-5.

7.      Mittal R, Jesudason MR, Nayak S. Selective histopathology in cholecyst-ectomy for gallstone disease. Indian J Gastroenterol. 2010;29:32-6.

8.      Pavlidis TE, Pavlidis ET, Symeonidis NG, Psarras K, Sakantamis AK (2012). Current curative surgical management of gallbladder cancer: a brief review. J Curr Surg, 2, 81-3.

9.      Khan RA, Wahab S, Khan MA, Siddiqui S, Maheshwari V (2010). Advanced presentation of Gallbladder cancer: epidemioclinicopathological study to evaluate the risk factors and assess the outcome. J Pak Med Assoc, 60, 217-9.

10.  Le MD, Henson D, Young H, Albores-Saavedra J (2011). Is gallbladder cancer decreasing in view of increasing laparoscopic cholecystectomy? Ann Hepatol, 10, 306-14.

11.  Tyagi BB, Manoharan N, Raina V (2008). Risk factors for gallbladder cancer : a population based case-control study in Delhi. Ind J Med and Paed Oncol, 29, 16-26.

12.  Shukla VK, Khandelwal C, Roy SK, Vaidya MP (1985). Primary carcinoma of the gallbladder: a review of a 16 year period at the University hospital. J Surg Oncol, 28, 32-5.

13.  Shiwani MH (2005). Surgical management of gall bladder carcinoma. Busi breif: Eur Gasteroenterol Rev, 1-5.

14.  Gupta SK, Shukla VK (2004). Gall bladder cancer etiopathology and treatment. Hlth Adm, 1052, 134-42.

15.  Piehler JM, Crichlow RW (1978). Primary carcinoma of the gallbladder. Surg Gynecol Obstet, 147, 929-42.

16.  Pandey M, Pathak AK, Gautam A, Aryya NC, Shukla VK (2001). Carcinoma of the gallbladder: a retrospective review of 99 cases. Digest Dis and Sci, 46, 1145-51.

17.  Shiwani MH (2007). Surgical management of gall bladder carcinoma. J Pak Med Assoc, 57, 87-90.

18.  Kapoor VK, Mc Michael AJ (2003). Gallbladder cancer: an ‘Indian’ disease. Natl Med J Ind, 16, 209-13.

19.  Levi F, Lucchini F, Negri E, La Vecchia C (2003). The recent decline in gallbladder cancer mortality in Europe. Eur J Cancer Prev, 12, 265-7.

20.  Lammert F, Matern S. The genetic background of cholesterol gallstone forma-tion: an inventory of human lithogenic genes. Curr Drug Targets Immune Endocr Metabol Disord. 2005;5:163-70.

21.  Shaffer EA. Gallstone disease: epidemiology of gallbladder stone disease. Best Pract Res Clin Gastroenterol. 2006;20:981-96.

22.  Everhart JE, Yeh F, Lee ET, et al. Prevalence of gallbladder disease in American Indian populations: findings from the Strong Heart Study. Hepatology. 2002;35:1507-12.

23.  Singh V, Trikha B, Nain C, Singh K, Bose S. Epidemiology of gallstone disease in Chandigarh: a community-based study. J Gastroenterol Hepatol. 2001;16:560-3.

24.  Dix FP, Bruce IA, Krypcyzk A, Ravi S. A selective approach to histopathology of the gallbladder is justifiable. Surgeon. 2003;1:233-5.

25.  Oommen CM, Prakash A, Cooper JC. Routine histology of cholecystectomy specimens is unnecessary. Ann R Coll Surg Engl. 2007;89:738.

26.  Bazoua G, Hamza N, Lazim T. Do we need histology for a normal-looking gallbladder? J Hepatobiliary Pancreat Surg. 2007;14:564-8.

27.  Darmas B, Mahmud S, Abbas A, Baker AL. Is there any justification for the routine histological examination of straightforward cholecystectomy specimens? Ann R Coll Surg Engl. 2007;89:238-41.

28.  Agarwal AK, Kalayarasan R, Sakhuja P. All cholecystectomy specimens must be sent for histopathology to detect inapparent gallbladder cancer. HPB (oxford). 2012;14(4):269-73.

29.  Siddiqui FG, Memon AA, Abro AH, Sasoli NA, Ahmad L. Routine histopathology of gallbladder after elective cholecystectomy for gallstones: waste of resources or a justified act? BMC Surg. 2013;13:26.

30.  Royal College of Pathologists. Histopathology and Cytopathology of Limited or No Clinical Value. Report of Working Group of the Royal College of Pathologists. 2nd. London: Royal College of Pathologists, 2005.

31.  Roa I, Araya JC, Villaseca M, Roa J, de Aretxabala X, Ibacache G. Gallbladder cancer in a high risk area: morphological features and spread patterns. Hepatogastroenterology. 1999;46:1540-6.

32.  Shrestha R, Tiwari M, Ranabhat SK, Aryal G, Rauniyar SK, Shrestha HG. Incidental gallbladder carcinoma: value of routine histological examination of cholecystectomy specimens. Nepal Med Coll J. 2010;12:90-4.

33.  Lohsiriwat V, Vongjirad A, Lohsiriwat D. Value of routine histopathologic examination of three common surgical specimens: appendix, gallbladder, and haemorrhoid. World J Surg. 2009;33:2189-93. 

Corresponding Author

Dr Swodeep Mohanty MS FMAS

Assistant Professor, Dept of Surgical Oncology, Acharya Harihar Regional Cancer Centre, Cuttack, Odisha, India,

Panda Medical Centre, Beparisahi, Cuttack, Odisha, India