Histological changes in gallbladder due to stone disease

Gallbladder stones are known to produce histopathological changes in the gallbladder. It is also one of the predisposing factors for the development of cancer of the gallbladder.
Aim: This work was carried out to study the diverse histopathological changes in the gallbladder mucosa as a result of cholelithiasis in the population of eastern Uttar Pradesh.
Materials and Methods: The study was conducted on 140 consecutive gallbladders, electively resected for cholelithiasis. Of these, 80 patients had symptoms related to stone disease while in 60 patients, the gallstones were asymptomatic and incidentally detected. The specimens were fixed in 10% formalin and submitted to detailed gross examination. For microscopy after hematoxylin and eosin staining, sections were obtained from the fundus, body and neck of the gallbladder. Additional sections were taken from grossly abnormal looking areas.
Results: On gross examination, it was found that outer gallbladder surface was congested in 40 patients (28.5%), wall thickness was increased in 60 (42.5%) and mucosal abnormalities were present in 90 patients (64.5%). At microscopy, epithelial hyperplasia was observed in 83 (69%), antral metaplasia in 23 (16.5%), intestinal metaplasia in 22 (15.5%), dysplasia in 12 (8.5%) and carcinoma in situ in 1 specimen (0.7%).
Conclusion: Gallstones are an important risk factor for cancer of gallbladder to develop. We found that cholelithiasis and even silent gallstones which were asymptomatic produced a series of epithelial pathological changes in the gallbladder mucosa, which could be precursor lesion of gallbladder carcinoma.