Incidental Diagnosis of Unplanned Gallbladder Carcinoma During or Following Laparoscopic Cholecystectomy

Résumé

Introduction:The most prevalent biliary tract cancer and the fifth most common type of gastrointestinal cancer is gallbladder carcinoma (GBC). Most individuals receive a diagnosis of GBC accidentally following a cholecystectomy for a presumably benign condition. Overt GBC that is clinically present is frequently far-progressed and unresectable. Those discovered by chance following open or laparoscopic cholecystectomy typically have early-stage tumors. It is an extremely fatal tumor. The incidental diagnosis of gallbladder cancer is more common due to the rise in cholecystectomies since laparoscopic cholecystectomy (LC) gained widespread acceptability. Analyzing incidental gallbladder cancer found during or following laparoscopic cholecystectomy was the goal of this investigation. Methods: This prospective study was conducted at the Department of Surgery, Naogaon Medical College, Naogaon, Bangladesh, from July 2018 to June 2020. A total of 250 patients were selected for this study purpose as per inclusion criteria. Statistical analysis of the results was obtained by using Statistical Packages for Social Sciences (SPSS-17) software.Result: In this study, most of the patients (100, 40.0%) belonged to the >60 years age group, followed by (80, 32.0%) 51-60 years age group.Among the study respondents, most of the patients (10,50.0%) were found to have poorly differentiated adenocarcinoma, followed by (05, 25.0%) moderately differentiated adenocarcinoma, (02, 10.0%) well-differentiated adenocarcinoma, primary malignant (02, 10.0%), and 01 (5.0%) patient were found to have metastatic cholangiocarcinoma.Regarding clinical presentation, most of the respondents (10, 50.0%) presented with pain in the right upper quadrant, followed by (05, 25.0%) moderate jaundice, pain with jaundice (03, 15.0%), and (2, 10.0%) pain with a palpable mass.Concerning clinical and histopathological diagnoses, 5 (25.0%) patients were primarily diagnosed as chronic cholecystitis with CBD stone but later they were found to have PDA in histology, another 5 (25.0%) patients were primarily diagnosed as obstructive jaundice with mirizzi syndrome but later they found to have PDA, ca of the head of the pancreas was diagnosed primarily in 5 (25.0%) patients who revealed MDA after histopathological analysis.Conclusion:Incidental diagnosis of gallbladder carcinoma was very high in this study (8.0%). Concerning clinical and histopathological diagnoses, 25.0% of patients were primarily diagnosed as chronic cholecystitis with CBD stone but later found to have PDA in histology, another 25.0% of patients were primarily diagnosed as obstructive jaundice with mirizzi syndrome but later they found to have PDA, ca of the head of the pancreas was diagnosed primarily 25.0% patients who revealed MDA after histopathological analysis.