Ann Hepatobiliary Pancreat Surg.  2023 Aug;27(3):277-286. 10.14701/ahbps.23-010.

Histopathological changes in gall bladder mucosa in relation to the number, and size of gallstones, and analysis of the findings in the context of age distribution of the patients: A perspective

• Sharma S
• Walia BS
• Randhawa M
• Sharma A
• Dugg P
• Pannu JS

• KMID: 2545774
• DOI: http://doi.org/10.14701/ahbps.23-010

Abstract

Backgrounds/Aims
To study histopathological changes in gall bladder mucosa in cholelithiasis patients, and analyse their relation to the number and size of gallstones. These findings were evaluated in the context of age distribution of the study population.
Methods
One hundred cases of cholecystectomy were part of the study, which was conducted in collaboration with the pathology department. The time period of the study was January 2020 to June 2021.
Results
Maximum cases had multiple stones (69.0%), while one third cases (31.0%) had solitary stones. While initial univariate analysis showed age (odds ratio [OR], 6.882; p = 0.043), gallstone number (OR, 9.1; p = 0.050), gallstone size (OR, 17.111; p = 0.013), and duration of symptom (OR, 34.125; p = 0.001) to be significant risk factors associated with gallbladder carcinoma, multivariate analysis found none of these variables to be significant. However, conditional multivariate analysis for the duration of symptom (p = 0.008; OR, 21.118) yielded significant p-value. With histopathological diagnoses, 5% of cases had gallbladder cancer.
Conclusions
This study shed light on the rising incidence of cholelithiasis in the young population and the high rate of gallbladder carcinoma in Punjab, India. Although gall stone characteristics (size, number) and patient age appeared to be significant risk factors when their individual relation with gallbladder carcinoma was studied, multivariate analysis, could not prove that. Conditional multivariate analysis showed the duration of symptom to be the only significant risk factor associated with gallbladder carcinoma. Further research with larger sample size is needed to study the rising incidence of gallbladder carcinoma, and the risk factors associated with it.

Keyword

Gallstones; Gallbladder neoplasms; Cholecystitis; Metaplasia

Figure

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  Fig. 1 Sex distribution of age groups (years).

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  Fig. 2 Chronic cholecystitis with Rokitansky-Aschoff sinus (H&E, ×10).

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  Fig. 3 Intestinal metaplasia, gallbladder (H&E, ×40).

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  Fig. 4 Adenocarcinoma gallbladder (H&E, ×40).

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  Fig. 5 Comparison of respective histopathological diagnoses with respect to size of gallstones (solitary/multiple).

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