‘Must go for biopsy after gall stone removal’

LUCKNOW: Biopsy after

gall bladder

stone removal operation is a patient’s right, said experts at surgical gastroentrology department of Sanjay Gandhi Post Graduate Institute of Medical Science, which is hosting a continuing medical education programme for doctors and students to mark the surgical gastroentrology week.

“Biopsy is is necessary to rule out risk of incidental cancer and every patient’s right,” said Prof Rajan Saxena, HoD, surgical gastroentrology, SGPGIMS, adding, “A number of surgeons miss this important aspect of gall bladder removal though cancer is diagnosed in 1% of all such operations.”

He added that 70% gall bladder cancer cases are diagnosed in those who undergo

surgery

for removal because of

stone

and it is very common in north India, especially in the Indo-Gangetic plains. “Stones cause chronic irritation to the walls of the gall bladder which prepares a site for cancer. The risk is high as, according to various studies, about 12-15% of population in state may complain of stones in gall bladder,” he said.

Co-faculty, Prof Annu Behari explained that approach to management of a patient who undergoes surgery for removal of gall bladder changes drastically if cancer is suspected. “By not getting a biopsy of the gall bladder removed, doctors are neglecting the patients as it can lead to spread of cancer,” she said.

Incidence of gall bladder cancer is high. An

Indian Council of Medical Research

document estimates that 17/100,000 have gall bladder cancer.

“In India, gall bladder cancer is most prevalent in Uttar Pradesh, Bihar, Orissa, West Bengal and Assam. It is twice more common in women than in men and is the commonest digestive cancer in women in northern India. The highest frequency of disease is in women over 65. Apart from gender, ethnicity, genetic susceptibility and lifestyle, gallstones are the associated risk factor,” read the report.


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