Incidental pathological findings in cholecystectomy: A single-center retrospective analysis

Aim: Chronic cholecystitis and cholelithiasis are the most frequently encountered pathologies in cholecystectomy specimens; however, additional histopathological findings that are not clinically suspected may incidentally be detected.This study aimed to evaluate the frequency and distribution of incidental pathological findings in patients who underwent cholecystectomy at a single center.Materials and Methods: The data of 3,084 patients who underwent cholecystectomy at our institution between January 2021 and December 2024, and for whom pathology reports were available, were retrospectively analyzed.Histopathological diagnoses other than chronic cholecystitis, acute cholecystitis, and cholelithiasis were considered incidental findings.These findings were classified according to their types, and their proportions were calculated.Results: Incidental pathological findings were detected in 390 of 3,084 cases (12.65%).The most frequent incidental lesions were metaplasia (n=182, 46.6%), adenomyomatous hyperplasia (n=79, 20.3%), and cholesterol polyps (n=77, 19.7%).Less common findings included xanthogranulomatous cholecystitis (n = 23, 5.9%), dysplasia (n = 18, 4.6%), and adenocarcinoma (n = 11, 2.8%).Among the adenocarcinoma cases, 81.8% occurred in women, with a mean age of 67.2 years.Discussion: Incidental pathological findings are observed at a noteworthy frequency in cholecystectomy specimens.The presence of clinically significant lesions such as metaplasia, dysplasia, and adenocarcinoma underscores the importance of routine histopathological examination of all gallbladder specimens.