Farsheed Sartaj, Mohammad Zarin, Umar Zia, Roohul Muqeem, Mahmood Aurangzeb, Dastgeer Waheed, Zille Huma.
Is routine histopathological examination of the gall bladder a futile exercise?.
Pak J Surg Jan ;20(2):71-4.

This study was conducted in Surgical “B” Unit of Khyber Teaching Hospital, Peshawar from October 1998 to November 2003 to look for the incidence of malignancy in apparently benign looking gall bladders. A total of 750 patients, 126 (16.80%) males and 624 (83.20%) females, were included in the study. Cholecystectomy was performed in all these patients for non-malignant diseases, mostly gall stones, and all the specimens sent for histopathology. The biopsy reports of these specimen showed chronic cholecystitis in 512 (68.27%) patients, acute cholecystitis / empyema in 225 (30%) and normal gall bladder in 10 (13.33%) patients; in the latter it was removed as part of other procedures. Three (0.40%) gall bladders, which did not reveal any evidence of malignancy on gross peroperative examination,had primary carcinoma at an early stage i.e. confined to mucosa only. It is, therefore, concluded that early stage carcinoma (Stage I) does occur in normal / non-neoplastic looking gall bladders at operation, but in a negligible number. However, it does not alter the management of these patients, as cholecystectomy is the only treatment for early carcinoma. Hence selective histopathology of gall bladder is safe and recommended, as it will save the un-necessary expenditure on routine biposy of every case.

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