Epidemiology of Gall Bladder Carcinoma As An Unexpected His- tologic Diagnosis in Patients Undergoing Cholecystectomy for Cholelithiasis. –A Prospective Study of 300 Cases

Biliary tract carcinomas which include cancer of the gall bladder and intrahepatic and extrahepatic biliary tree are relatively infrequent but highly lethal diseases that are notoriously difficult to diagnose and treat. Objective: To study the relation of gallstones and malignant histopathological changes in gallbladder with correlation of size and no. of gallstones in causation or predisposition to gallbladder carcinoma. Methods: A prospective study was conducted at the Govt. Medical College, Patiala, on 300 patients with cholecystectomy for cholelithiasis and extensive review was done with special reference to the histopathological findings and correlation of size and no. of gallstones in causation or predisposition to gallbladder carcinoma Results: Out of 300 cholecystectomies performed during the period of study, most of the patients belonged to the age group of 31-50yrs with M: F ratio of 1:5 and the size of the largest stone measured was <3cm in 88% and >3cm in 22%. Patients diagnosed to have gallbladder carcinoma in our series had size between 2-2.9 cm in diameter. 4 patients (1.15%) were diagnosed to have gall bladder carcinoma on histopathology. Conclusion: Cholelithiasis is a disease more prevalent in females in age group of 31-50years with multiple gallstones. Early onset of gallstone disease , especially in women, and late presentation of patients for surgical treatment result in prolonged exposure of the gallbladder to gallstones , increasing size of gallstone with increasing age and various complications of long standing cholelithiasis , all are risk factors for gallbladder carcinoma.