Irum Masood, Haris Rasheed, Ahmed Raheem.
Cohort study: occurrence rate of occult gallbladder carcinoma and its curative strategies.
Pak J Surg Jan ;32(4):245-9.

Background: Gallbladder specimen after cholecystectomy is one of the rarely come up against in routine histopathology. Accompanied by the great supposition, nearly all gallbladder specimens harbor the benign disease, but once in a while unexpected to find malignancy. Occult gallbladder carcinoma is uncommon, highly lethal, although it is fifth prevailing malignancy in the gastrointestinal tract. Gallbladder malignancy is possible to cure if diagnosed at early stage and promptly treated surgically. Aim of study to figure out the occurrence of incidental carcinoma of the gallbladder and its curative options after elective cholecystectomy detected in routine histopathology. Methods: Cohort study was done in total 1522 specimens of gallbladder, that were submitted in the pathology department in Ziauddin University and Hospital, five years of duration from Jan 2011 to Dec 2015, that were searched retrospectively for incidence of occult gallbladder carcinoma. Result: We found 16(1.05%) cases of occult gallbladder carcinoma out of 1,522 patients, 4(25%) well differentiated, 9(56.25%) moderately differentiated, 2(12.5%) poorly differentiated and 1(6.25 %) was undifferentiated adenocarcinoma. The incidence rate of primary malignancy was 1.05% and commonly found in female with the complete number of laparoscopic cholecystectomies carried out in that time. During follow up two patients lost, rest of the patients no recurrence or metastasis seen at 6, 12 and 24 months but one patient still not completed two years follow up. Conclusion: Gallbladder malignancy may be curable if diagnosed in early stages. Laparoscopic cholecystectomy may not worsen the prognosis in such cases. Therefore every gallbladder specimen should be examined histopathologically after cholecystectomy to detect possible occult gallbladder carcinoma.

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