165 Incidence of Gallbladder Carcinoma in Cholecystectomy Specimens: A Retrospective Review

Abstract Background Gallbladder carcinoma (GBC) is a rare but aggressive malignancy, often diagnosed incidentally following cholecystectomy for presumed benign conditions such as cholelithiasis, cholecystitis. While gallbladder polyps are considered a risk factor, most gallbladder cancers are detected in patients without preoperative suspicion. Understanding the incidence of incidental carcinoma in all gallbladder specimens is crucial for guiding surgical practice and histopathological screening. Method This retrospective cohort study analysed all cholecystectomy specimens processed at a tertiary care centre between January 2020 and December 2024. Demographic data, surgical indications, imaging findings, and histopathological diagnoses were reviewed to identify cases of gallbladder carcinoma and their clinical context. Results A total of 806 cholecystectomies were performed during the study period. Gallbladder carcinoma was identified in 3 cases, yielding an overall incidence of <1%. Among these, only one case was preoperatively suspected due to gallbladder polyps, while the remaining were incidental findings in specimens removed for Cholelithiasis. No high-risk features were documented preoperatively in most cases. Conclusions The incidence of gallbladder carcinoma among all cholecystectomy specimens remains low but clinically significant. Most cases are diagnosed incidentally, highlighting the importance of routine histopathological examination of all gallbladders, even when malignancy is not suspected. These findings support continued vigilance in pathological assessment and may inform future discussions on risk stratification and surgical decision-making.