Association of Gall Bladder Carcinoma with Gall Stones; A Single Centre Study in a  Tertiary Care Hospital

Objective: To evaluate the occurrence of gall bladder carcinoma and its association with gall stones in patients undergoing cholecystectomies. Study Design: Cross sectional study. Place and Duration of Study: Army Liver Transplant Unit, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Feb 2020 to Jun 2022. Methodology: We enrolled 500 patients, between the ages of 18 to 80 years, presenting to outpatient department of a tertiary care hospital, with complaints of gall stone disease, and planned for cholecystectomy. Detailed history was obtained, along with laboratory investigations and abdominal ultrasonography. Gall bladder samples were sent to Armed Forces Institute Pathology for reporting by a consultant pathologist. Results: Out of 500 patients enrolled for the study, 330(66%) were females and 170(34%) were males, with the mean age of 45.00±8.87 years. Histopathological findings revealed 455(91%) cases of inflammation, 27(5.4%) cases of dysplasia and 18(3.6%) cases of carcinoma. A significant association was observed between age and gall bladder carcinoma (p-value <0.001). Number of stones had no significant association, but size of stone had strong association with gall bladder carcinoma (p-value=0.001). Conclusion: Gall stones have a strong link to the malignancy of gall bladder, more specifically in old age and among females having larger sized gall stones. Early cholecystectomies are recommended, especially with larger (>3cm) stones.