Incidence &types of gall bladder cancer in chronic calculus cholecystitis in Al-nasseryia city

Abstract

   Chronic cholecystitis is a persistent inflammatory disorder of the gall bladder, commonly arising from recurrent mild or subclinical bouts of acute cholecystitis. It is marked by mucosal atrophy, fibrotic thickening, and distortion of the gallbladder wall. The condition is strongly associated with gall stones, whose continuous mechanical irritation and intermittent obstruction lead to progressive fibrosis, structural alteration, and chronic inflammation . Laparoscopic or open cholecystectomy operations are the common operations done in AL nassiriya city due to acute or chronic calculus cholecystitis. Chronic calculus cholecystitis may be associated with malignant changes because of chronic irritation, which is usually preceded by metaplasia due to irritation, dysplasia, carcinoma in situ, and then invasive carcinoma.   360 patients undergoing successful laparoscopic or open cholecystectomy for chronic calculus cholecystitis, all gall bladders are sent for histopathological examination to detect any malignant changes.   Several cases of chronic calculus cholecystitis have developed malignant changes. Tubular adenocarcinoma, most frequently observed in women with gallstones, exhibits a downward invasive growth pattern and carries a poor prognosis. Chronic cholecystitis and epithelial metaplasia are commonly present, while undifferentiated carcinomas also prevalent among females with gallstones, demonstrate the most adverse clinical outcomes. Patients with chronic calculus cholecystitis should be treated by laparoscopic or open cholecystoctomy as soon as possible to prevent hazards of malignant changes that may be associated with chronic irritation of the stones to the gall bladder mucosa and because of histopathological types of ca. bladder that associated with gall stones are either tubular adenocarcinoma or undifferentiated carcinoma which have bad prognosis thus, after operation should send the gall bladder for histopathological examination to detect any malignant changes and deal with it as early as possible.