Routine Histopathology of Gallbladder After Elective Surgery for Gallstones is Waste of Resources or Justified

Abstract

Objective: To determine the need for routine histopathological analysis of gallbladder specimens post-cholecystectomy in Pakistan, focusing on detecting unexpected pathologies.

Methodology: This descriptive cross-sectional study was conducted at Islamabad Medical Complex, NESCOM, 1st august 2022 to 31st October 2023, involving 534 patients who were diagnosed with gallstones-induced acute or chronic cholecystitis, while excluding those with clinical or radiological indications of gallbladder carcinoma. All surgical specimens were carefully submitted for histopathological analysis, and the collected data were systematically evaluated using SPSS 26 version.

Results: Overall 534 mean age of patients was 49.03 +15.02 years. The chronic cholecystitis was the most frequent histopathological finding (85.0%), followed by acute on chronic cholecystitis (13.5%), while rare lesions included gallbladder polyps (0.7%) and mucinous adenocarcinoma (0.7%). Additionally, the distribution of histopathological outcomes across different age groups (p = 0.527) and between genders (p = 0.988) showed no statistically significant differences.

Conclusion: Study revealed that most gallbladder specimens following elective cholecystectomy for gallstones showed benign pathology, predominantly chronic cholecystitis, with only rare lesions such as gallbladder polyps or mucinous adenocarcinoma, and although incidental malignancy was uncommon, which indicating that the routine histopathological examination remains essential and justified to ensure early detection of unexpected neoplastic changes that could be missed on gross examination.