Histopathological variants of gallbladder after cholecystectomy in Eastern Libya: A report of 3412 specimens

Background: Cholecystectomy is one of the most common surgical operations and is performed routinely for a variant of gallbladder diseases, including chronic and acute cholecystitis and gallbladder cancer (GBC). The gallbladder is one of the most commonly encountered specimens submitted to histopathology department. The aim of this study was to determine the histopathological pattern of gallbladder lesions in cholecystectomy specimens in two university hospitals in the Eastern part of Libya. Material and methods: From January 2009 to June 2017, all histopathology reports of 3423 consecutive gallbladder specimens after elective and emergency cholecystectomy were retrospectively analyzed in two university hospitals. Results: Of the 3423 gallbladder specimens sent for histopathological examination during the study period, 486 were male (14.2%) and 2937 were female (85.8%), with a mean age of 42 (14 to 93) years. Chronic cholecystitis was found in 2792 (81.6%), acute cholecystitis in 237 (6.9%) and cholesterosis in 223 (6.5%) patients. GBC was detected in 4 (0.11%) patients. Incidence of chronic cholecystitis was significantly higher in female (n=2425; 82.6%) than in male (n= 367; 75.5%) patients (P < 0.001). However, acute cholecystitis, empyema of the gallbladder, and gangrenous cholecystitis were more common in males than females (8.6% vs 6.6%; 4.3% vs 0.9%; and 2.5% vs 0.8% respectively). Conclusion: The histopathological spectrum of gallbladder after cholecystectomy was observed to be quite diverse. The most prevalent diagnosis was chronic cholecystitis followed by acute cholecystitis and cholesterosis of the gallbladder, whereas carcinoma of the gallbladder was rarely observed. Although chronic cholecystitis is more common in females, the incidence of complications such as acute cholecystitis, empyema of gallbladder, and gangrenous cholecystitis were more common in males than females.