STANDARDIZED HISTOLOGICAL REPORTING OF CHOLECYSTECTOMIES FOR CHRONIC CHOLECYSTITIS; IS IT VALID?

ABSTRACT
Objectives: The objective of the study was to standardize a reporting system for histological examination of chronic
inflammatory patterns in surgically resected gall bladder specimens and to emphasize the importance of this detailed
examination.
Materials and Methods: Total numbers of cases included in this study were 450 who had their cholecystectomies done
for chronic cholecystitis. Representative sections were taken from each specimen and processed routinely. Histopathologist
examined H & E stained slides. The histopathological findings were recorded in accordance with a uniform
checklist and scored according to laid down criteria.
Results: 342 specimens were from female patients and 108 specimens were from males. Their ages ranged from 16
to 86 years. 60% presented with chronic cholecystitis with cholelithiasis and in 40% of cases there were no gallstones.
Mucosal hyperplasia was observed in 76% of cases. Inflammatory mononuclear cells infiltrate was present in all specimens
and inflammatory activity was seen in 47% of the cases. 50% cases had metaplastic epithelium, dysplasia in
5.6% and carcinoma in 0.44% of cases.
Conclusion: It is concluded that this approach will provide a rational, systematic and reproducible diagnosis to the
clinician so that they can have an accurate idea of the magnitude of the disease or any potential for simultaneous
complications.
Key Words: Chronic cholecystitis, cholecystectomy, metaplasia