Retrospective Cohort Study
Copyright ©The Author(s) 2016.
World J Gastrointest Surg. Oct 27, 2016; 8(10): 685-692
Published online Oct 27, 2016. doi: 10.4240/wjgs.v8.i10.685
Table 1 Summary of histopathological findings
HistologySubgroupNo (n = 4027)% Total
Normal1824.50%
Cholecystitis348086.3%
Acute45
ChronicGangrenous3435
Empyema29
Follicular6
Xanthogranulomatous3
5
Cholesterosis2466%
Polypoidal Lesion4410%
Cholesterol-based42
Hyperplastic1
Adenoma1
Metaplasia130.3%
Dysplasia551.4%
Focal LGD*40
Multi-Focal LGD9
Focal HGD2
Multi-focal HGD4
(Multi-focal HGD + AC)(2)
Carcinoma in situ10.02%
Adenocarcinoma60.15%
Table 2 Pre- and post-operative characteristics of cases with incidental gallbladder adenocarcinoma
AgeSexPre-operative imagingOperation detailsOperative findingsTumour type/stagingFurther managementSurvival (mo)
71FUSS: Multiple gallstonesLapSmooth GB wall with multiple calculiT1a N0 M0, AdenocarcinomaNo further operation, surveillance CT scansAlive (64)
68FUSS: Multiple stones, dilated CBD; CT: Multiple stones, no mass seenOpenLarge GB calculi, no CBD stones on CBD explorationT2 N0 M0, Adenocarcinoma (MD)Not fit for further resection (known chronic leukaemia – already on chemotherapy)Alive (22)
45FUSS: Stones, thickened GB wall; CT: Inflammatory changes on GB wallLap converted to openSmall abscess on GB bed, gross GB wall thickeningT3 N1 M0, Adenocarcinoma (PD)Revision operation – abandoned as nodules on umbilical port and peritoneum, palliative chemotherapy12
70FUSS: Grossly thickened GB wall and multiple gallstonesLapThick dense adhesions with fistulous communication between GB tumour and transverse colonT3 N1 M1, Adenocarcinoma (PD)Chemotherapy12
65FUSS: Stones, cholecystitis; CT: Marked GB wall thickening, ?cholecystitisLapGB wall inflamed, disintegrated with biliary spillage++T2 N0 M0, Adenocarcinoma (MD)Not medically fit for revision surgery; developed nodal disease but not fit for chemo; palliative therapy37
65MUSS: Sludge and gallstones (pancreatitis patient)LapMildly inflamed GB with calculiT1b N0 M0, Adenocarcinoma (PD)Revision surgery and lymphadenectomy, chemotherapyAlive (36)
66MUSS: Multiple small gallstonesLapSmooth GB wall with calculiTis N0 M0No further managementAlive (54)