Proportion of Incidental Gallbladder Carcinoma in Cholecystectomy Specimens for Gallstone Disease and Its Association with Patient Biosocial Factors

Background: Incidental gallbladder carcinoma is an aggressive malignancy often detected unexpectedly after cholecystectomy for gallstone disease, with prognosis highly dependent on early histopathological identification. Objective: To determine the proportion of incidental gallbladder carcinoma in cholecystectomy specimens for gallstone disease and to evaluate its association with patient biosocial and gallstone-related variables. Methods: A descriptive cross-sectional study was conducted at the Department of Surgery, Rajshahi Medical College Hospital, from July 2018 to June 2021. A total of 302 purposively selected patients undergoing cholecystectomy for gallstone disease were included. Demographic characteristics, clinical presentation, gallstone number and size, and histopathological outcomes were analyzed using descriptive and inferential statistics. Results: The mean age of patients was 39.17 ± 8.0 years. Females constituted 70.2% (SD ± 2.6). Incidental gallbladder carcinoma was identified in a small but clinically significant proportion of specimens, predominantly among patients aged >50 years (mean age 56.4 ± 6.8 years; p = 0.014). Female sex showed higher carcinoma frequency (p = 0.041). Chronic cholecystitis was significantly associated with malignancy compared to acute presentations (p = 0.032). Patients with multiple gallstones >2 cm demonstrated a higher carcinoma proportion (38.1%; SD ± 4.2) than those with smaller or solitary stones (p = 0.019). Stone size showed a positive correlation with malignant histology (r = 0.46). Age variability among carcinoma cases was narrower (SD ± 5.1), indicating clustering in older age groups. Conclusion: Incidental gallbladder carcinoma is significantly associated with advanced age, female sex, chronic gallstone disease, and large multiple stones, supporting routine histopathological examination of all cholecystectomy specimens.