Incidental Gall Bladder Carcinoma in Patients Undergoing Cholecystectomy in a Tertiary Care Hospital

Objective: To determine the frequency of carcinoma of Gall Bladder in Hospitalized patients undergoing surgeries for cholelithiasis at tertiary care Hospital. Study Setting: General surgery department of Muhammad Medical College Mirpurkhas. Study Design: Descriptive. Study Duration: From 2018 to 2019. Methodology: All the patients of cholelithiasis diagnosed via trans-abdominal ultrasound, those who underwent cholecystectomies and either of gender were included. After surgeries, specimens immediately were sent to the Hospital diagnostic laboratory to evaluate the gall bladder carcinoma. The information obtained was noted on a pre-designed proforma. Results: A total 200 patient of gall bladder stone disease were observed who underwent cholecystectomies. Average age was 53.8+5.62 years and male to female ratio was 1:2.5. Incidence of carcinoma of gall bladder was 4%, which was significantly associated to gall bladder mass, chronic calculus cholecystitis and porcelain gall bladder (p=0.001). Conclusion: The incidence of the gall bladder cancer in the study population was 4% and its relationship with gall bladder diseases (chronic cholecystitis and porcelain) was found to be significant.

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Role of EGFR and HER-2/NEU Expression in Gall Bladder Carcinoma

Journal of Laboratory Physicians ◽

10.1055/s-0041-1726561 ◽

2021 ◽

Author(s):

Chhanda Das ◽

Madhumita Mukhopadhyay ◽

Srijana Subba ◽

Ashis Kumar Saha ◽

Biswanath Mukhopadhyay

Keyword(s):

Gall Bladder ◽

Bladder Carcinoma ◽

Tertiary Care ◽

Molecular Therapy ◽

Tumor Type ◽

Care Hospital ◽

Gall Bladder Carcinoma ◽

Poorly Differentiated ◽

Her 2 ◽

Well Differentiated

Abstract Background Gall bladder carcinoma (GBC) is the most common malignancy of the biliary tract. Being known for its geographical and racial variations, and compared with the global statistics, its incidence is higher in the Indian subcontinent, mainly in the northern and eastern regions, accounting for 80 to 95% of cases. Aims and Objectives This study was conducted to evaluate the clinic-pathological spectrum and expression of EGFR and HER-2/NEU in GBCs and to understand their relation to prognosis, paving the way for targeted therapies for better treatment outcomes and patient survival. Materials and Methods This is a prospective study performed in a tertiary care hospital in 30 resected specimens of GBC cases recorded in our Department of Pathology from November 2017 to November 2019. Clinical history including the radiological reports and demographic parameters were included in the study pro forma. Immunohistochemical (IHC) staining for EGFR and HER-2/NEU was performed on all the selected cases. Clinicopathologic parameters like age, sex, histologic type, perineural, and lymphovascular invasion were compared and correlated with EGFR and HER-2/NEU status. Results Expression of EGFR was found in 93.33% of cases, which showed a highly significant correlation with histological tumor type (p = 0.000). HER-2/NEU expression was found in 56.66% of cases, which also showed a significant correlation with histological tumour type (p = 0.021). We found most of the cases with strong EGFR immunoreactivity (3+) were poorly differentiated tumors and most of the cases showing weak immunoreactivity for EGFR (1+) were well-differentiated. Conversely, in case of HER-2/NEU immunoreactivity, strong staining (3+) was seen in well-differentiated tumors and weak staining (1+) in poorly differentiated tumors. A significant correlation was also found between EGFR and HER-2/NEU expression (p = 0.000) and between cholelithiasis and EGFR expression (p = 0.033). Conclusion EGFR is expressed in most cases of GBC. Its expression is more in poorly differentiated carcinomas as compared to the well-differentiated carcinomas, whereas HER-2/NEU expression is more in well-differentiated carcinomas. Therefore, they may serve as independent prognostic factors and also as targets for molecular therapy in GBCs.

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Spectrum of computed tomography findings in gall bladder carcinoma patients: a retrospective observational study from tertiary care oncology setup

International Surgery Journal ◽

10.18203/2349-2902.isj20202809 ◽

2020 ◽

Vol 7 (7) ◽

pp. 2091

Author(s):

Palwasha Gul ◽

Pari Gul ◽

Omer Altaf ◽

Talha Yaseen Kaimkhani ◽

Hira Asghar

Keyword(s):

Computed Tomography ◽

Gall Bladder ◽

Bladder Carcinoma ◽

Bladder Wall ◽

Tertiary Care ◽

Research Centre ◽

Therapeutic Window ◽

Imaging Findings ◽

Gall Bladder Carcinoma ◽

Contrast Enhanced Ct

Background: Gallbladder carcinoma (CA) is the most common primary biliary carcinoma and fifth most common malignancy of the gastrointestinal tract. Patients are usually asymptomatic early in the course of the disease and as a result, therapeutic window is usually missed. Authors discuss spectrum of imaging findings in CA gall bladder with multidetector computed tomography (CT) as modality of choice.Methods: Retrospective cross-sectional study conducted at Shaukat Khanum memorial hospital and research centre. Data from January 2019 to January 2020 which included 70 patients was collected from HIS. Patients with imaging findings of CA gall bladder were examined who had undergone contrast enhanced CT. Institutional review board approved this study.Results: Out of 70 cases in this study, cholelithiasis was present in 60%. The commonest MDCT finding was mass replacing GB (78.6%), followed by eccentric/diffuse gall bladder wall thickening. Extension to porta hepatis was noted in 25 (35.7%) cases. Antroduodenal involvement was noted in 11 (15.8%), hepatic flexure involvement in 8 (11.4%). Vascular encasement/thrombosis of the portal vein noted in 6 (8.6%). Metastasis at presentation was seen in 16 patients i.e., 22.9%. Majority patients presented with stage III and IV disease.Conclusions: Single-center tertiary care oncology hospital study gives insight about imaging findings of carcinoma gallbladder. Authors conclude that multidetector CT is the diagnostic tool of choice in detection of gall bladder carcinoma, locoregional disease, distant metastasis and hence operability and non-operability of the disease.

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Clinicopathological study of gall bladder carcinoma with special reference to its management in a tertiary care hospital

International Surgery Journal ◽

10.18203/2349-2902.isj20205367 ◽

2020 ◽

Vol 7 (12) ◽

pp. 4120

Author(s):

Debmalya Saha ◽

Saket Jha ◽

Sukalyan Chhaule ◽

Rabin Mandal ◽

Anadi Acharya ◽

...

Keyword(s):

Gall Bladder ◽

Gallbladder Cancer ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Treatment Protocol ◽

Rank Test ◽

Common Symptom ◽

Care Hospital ◽

Female Ratio ◽

Mortality And Morbidity

Background: Incidence of gallbladder carcinoma is increasing progressively among Indians and is regarded as a major cause of mortality and morbidity. In spite of this, limited studies have been conducted so far. Objective of the study was to know the prevalence, clinicopathological aspects, and prevalent treatment protocol of gall bladder cancer in a tertiary care hospital in Eastern India.Methods: 64 cases of histologically proven gallbladder cancer patients were studied. Patient characteristics were recorded using pretested proforma along with relevant investigations, and histopathology and treatment provided were recorded.Results: Our study reveals that gallbladder cancer has a prominent peak in the 7th decade of life with male: female ratio of 1:2.2. Most of the patients were having body mass index between 20.0 and 24.99, which is in sharp contrast to the available literatures. Pain is the most common symptom followed by constitutional symptoms. Majority of cases presented at advanced stage (64.1%) with significantly elevated CA19.9 level, and were managed with palliative chemotherapy.35.9% of our cases were respectable at the time of diagnosis, and extended cholecystectomy could be performed in 31.3%. Log rank test showed pattern of survival of the patients who were resected was significantly better than those of who were not resected.Conclusions: We know gallbladder cancer is a disease with very few patients amenable to surgery at the time of presentation. Thus, instead of retrospectively analyzing individual institutional data, high volume institutions with the necessary expertise for treating gallbladder cancer should collaborate with a view of generating strong evidence-based surgical guidelines.

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