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Incidental Carcinoma Gallbladder: Incidence, Risk Factors, and Factors Affecting Survival—5-Year Experience from a Tertiary Care Institute

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Abstract

Introduction

Carcinoma gallbladder is a very lethal disease. It can get detected incidentally after laparoscopic cholecystectomy. The overall outcome of incidentally detected carcinoma gallbladder is a matter of debate in literature.

Aim

To estimate the overall incidence of the incidental gallbladder carcinoma, the various risk factors associated with it and factors affecting overall survival in patients who underwent laparoscopic cholecystectomy with eventual histology turning out to be carcinoma gallbladder.

Methods

Data of all the patients undergoing laparoscopic cholecystectomies in one surgical unit under the Department of Surgery at All India Institute of Medical Sciences, New Delhi, India, between January 2014 and December 2018 was retrospectively analyzed. All patients with incidental carcinoma gallbladder were followed up and completion radical cholecystectomy was performed. The demographic profile, preoperative imaging, intra-operative finding, histopathology of primary surgery, and median interval between two surgeries were analyzed to look for various risk factors associated with incidental carcinoma gallbladder and factors affecting overall survival.

Results

Incidence of the incidental carcinoma gallbladder was 0.51% with a female/male ratio of 4:1 and mean age of 47.2 years. Preoperative imaging of most of them was suggestive of chronic cholecystitis; however, one patient had multiple gallbladder polyps. Six patients had uneventful laparoscopic cholecystectomy, while four had bile spillages intraoperatively. All the patients had adenocarcinoma on histopathology. Pathological staging of four patients was pT1b and six patients had pT2 tumor. The median interval between cholecystectomy and completion radical cholecystectomy in this series was 8 weeks. At the end of 19-month median follow-up, overall survival was 55.5%.

Conclusion

Incidence of incidental carcinoma gallbladder is 0.51%, most commonly affecting middle-aged females. Risk factors associated with incidental carcinoma gallbladder were found to be multiple gallbladder calculi, single large stone, and gallbladder polyps. Survival is better in males, young patients with uneventful primary surgery and better-differentiated pathology.

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Abbreviations

WD:

Well differentiated

MD:

Moderately differentiated

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Authors and Affiliations

  1. Department of Surgical Disciplines, All India Institute of Medical Sciences, Room no. 5025, 5th Floor, Ansari Nagar, New Delhi, 110029, India

    Bhanu Pratap Singh, Washim Firoz Khan, Yashwant Singh Rathore & Manjunath Maruti Pol

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  1. Bhanu Pratap Singh
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  2. Washim Firoz Khan
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  3. Yashwant Singh Rathore
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  4. Manjunath Maruti Pol
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Correspondence to Yashwant Singh Rathore.

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Singh, B.P., Khan, W.F., Rathore, Y.S. et al. Incidental Carcinoma Gallbladder: Incidence, Risk Factors, and Factors Affecting Survival—5-Year Experience from a Tertiary Care Institute. J Gastrointest Canc 51, 980–987 (2020). https://doi.org/10.1007/s12029-019-00347-1

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