The histopathological spectrum of cholecystectomy tissue samples at an academic laboratory in Northern Pretoria, South Africa

Abstract

Introduction: Cholecystectomy, the surgical removal of the gallbladder, is commonly performed to treat gallstones (cholelithiasis). These stones, primarily composed of cholesterol or bilirubin, can lead to symptoms ranging from mild discomfort to severe complications. Cholelithiasis is also one of the risk factors for gallbladder carcinoma. Histopathological examination of gallbladder specimens is crucial in understanding disease pathogenesis and optimising patient management.
Methods: This retrospective study analysed the histopathological findings of cholecystectomy specimens collected over five years within the Department of Anatomical Pathology at the Dr George Mukhari Academic Laboratory, National Health Laboratory Service (NHLS), Pretoria, South Africa. The study aimed to assess the clinicopathological spectrum of gallbladder diseases. Data analysis was conducted using Epi Info™ version 7.1.5. Descriptive statistics were used to analyse and summarise the demographic and clinicopathological data. Chi-square and Fisher’s exact tests were used to determine associations between variables.
Results: A total of 317 cholecystectomy cases were reviewed, with most cases from females (276, 87.1%) and 41 cases (12.9%) from males. The average patient age was 42.84 ± 13.76 years, ranging from eight to 84 years, with the highest prevalence (30.1%) of gallbladder disease noted in the third decade. Gallstones were found in 63% of cases, with a significant predominance in females (93.5%). A statistically significant correlation was observed between sex (male and female) and gallstones (p < 0.001). Histopathological findings revealed carcinoma in 3% of cases, acute cholecystitis in 6%, and chronic cholecystitis as the most frequent diagnosis at 91%.
Conclusion: The study revealed a broad age range among patients with gallbladder disease, with a significant female predominance. Chronic cholecystitis was the most common histopathological diagnosis. The diagnosis of carcinoma highlights the importance of timely and thorough histopathological evaluation in gallbladder disease for improved patient management.