{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:37:21Z","timestamp":1787071041356,"version":"build-2736575974"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Gallstone disease (GSD) has a high prevalence in India. GSD presentation varies from being asymptomatic to severe complications. Laparoscopic cholecystectomy (LC) is the procedure of choice. Histopathological varies from chronic cholecystitis to carcinoma gall bladder (CaGB). Thick wall gall bladder (TWGB) is grey zone. Various parameters of GSD especially TWGB were evaluated to develop an approach to reduce perioperative complications and histopathological surprises.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods:<\/jats:title>\n                    <jats:p>This study was conducted at the Department of Surgical Gastroenterology, Dr. RMLIMS, Lucknow. Data of all patients undergoing cholecystectomy between January 2015 and March 2023 were analysed retrospectively. Demographic profile, clinical presentation, blood investigations, radiological findings, operative findings and histopathology report were examined. Clinical and radiological features of difficult cholecystectomies, incidence and type of bile duct injury (BDI), presentation and outcomes of TWGB, incidence of incidental CaGB and its outcome, were evaluated and analysed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 5450 patients underwent cholecystectomy during the study period. GSD is common in females and 4\n                      <jats:sup>th<\/jats:sup>\n                      decade. The laparoscopic to open conversion rate was 1.2%, the most common cause was unclear anatomy. The incidence of BDI in our series was 0.11% (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 6). The most common histopathological outcome was chronic cholecystitis followed by xanthogranulomatous cholecystitis. Incidence of incidental carcinoma gall in our series was 0.3% (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 16) with an overall survival of 68.75% at a mean follow-up of 19.4 months. TWGB workup includes contrast-enhanced computed tomography, intraoperative most have difficult cholecystectomy and had a higher rate of conversion, injury and incidental CaGB.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Thorough pre-operative evaluation and using the suggested algorithm may decrease perioperative complications and histopathological surprises after LC.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jmas.jmas_209_24","type":"journal-article","created":{"date-parts":[[2024,11,29]],"date-time":"2024-11-29T09:00:09Z","timestamp":1732870809000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["An institutional approach to thick wall gall bladder and our experience of 5450 gallstone disease"],"prefix":"10.4103","author":[{"given":"Bhanu Pratap","family":"Singh","sequence":"first","affiliation":[{"name":"Department of Surgical Gastroenterology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anshuman","family":"Pandey","sequence":"additional","affiliation":[{"name":"Department of Surgical Gastroenterology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hitesh","family":"Sarda","sequence":"additional","affiliation":[{"name":"Department of Surgical Gastroenterology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. N.","family":"Hareesh","sequence":"additional","affiliation":[{"name":"Department of Surgical Gastroenterology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sudip","family":"Regmi","sequence":"additional","affiliation":[{"name":"Department of Surgical Gastroenterology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,11,29]]},"reference":[{"key":"R1-20241129","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1007\/s11894-005-0051-8","article-title":"Epidemiology and risk factors for gallstone disease:Has the paradigm changed in the 21st century?","volume":"7","author":"Shaffer","year":"2005","journal-title":"Curr Gastroenterol Rep"},{"key":"R2-20241129","first-page":"487","article-title":"Gallstone disease menacing rural population in north India:a retrospective study of 576 cases in a rural hospital","volume":"2","author":"Mukesh","year":"2015","journal-title":"Int Surg J"},{"key":"R3-20241129","doi-asserted-by":"crossref","first-page":"809","DOI":"10.1002\/hep.510260401","article-title":"Factors associated with gallstone disease in the MICOL experience. Multicenter Italian study on epidemiology of cholelithiasis","volume":"26","author":"Attili","year":"1997","journal-title":"Hepatology"},{"key":"R4-20241129","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1053\/j.gastro.2005.05.016","article-title":"Glycemic load, glycemic index, and carbohydrate intake in relation to risk of cholecystectomy in women","volume":"129","author":"Tsai","year":"2005","journal-title":"Gastroenterology"},{"key":"R5-20241129","first-page":"66","article-title":"Fundus-first technique and partial cholecystectomy for difficult laparoscopic cholecystectomies","volume":"24","author":"Sormaz","year":"2018","journal-title":"Ulus Travma Acil Cerrahi Derg"},{"key":"R6-20241129","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1016\/j.amjsurg.2009.08.020","article-title":"Trends, outcomes, and predictors of open and conversion to open cholecystectomy in Veterans health administration hospitals","volume":"200","author":"Kaafarani","year":"2010","journal-title":"Am J Surg"},{"key":"R7-20241129","doi-asserted-by":"crossref","first-page":"800","DOI":"10.1016\/S1091-255X(02)00064-1","article-title":"Reasons for conversion from laparoscopic to open cholecystectomy:A 10-year review","volume":"6","author":"Bingener-Casey","year":"2002","journal-title":"J Gastrointest Surg"},{"key":"R8-20241129","first-page":"123","article-title":"Analysis of complications and clinical and pathologic factors in relation to the laparoscopic cholecystectomy","volume":"93","author":"Li\u0161ka","year":"2014","journal-title":"Rozhl Chir"},{"key":"R9-20241129","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1080\/13651820310015293","article-title":"Laparoscopic cholecystectomy:Incidents and complications. A retrospective analysis of 9542 consecutive laparoscopic operations","volume":"5","author":"Duca","year":"2003","journal-title":"HPB (Oxford)"},{"key":"R10-20241129","doi-asserted-by":"crossref","first-page":"1028","DOI":"10.1001\/archsurg.1990.01410200092014","article-title":"Iatrogenic injury to the bile duct Who, how, where?","volume":"125","author":"Moossa","year":"1990","journal-title":"Arch Surg"},{"key":"R11-20241129","first-page":"101","article-title":"An analysis of the problem of biliary injury during laparoscopic cholecystectomy","volume":"180","author":"Strasberg","year":"1995","journal-title":"J Am Coll Surg"},{"key":"R12-20241129","doi-asserted-by":"crossref","first-page":"91","DOI":"10.18231\/j.achr.2020.018","article-title":"Histopathological spectrum of gallbladder diseases in cholecystectomy specimens at a rural tertiary hospital of Purvanchal in North India \u2013Does it differ from South India?","volume":"5","author":"Kotasthane","year":"2020","journal-title":"IP Arch Cytol Histopathol"},{"key":"R13-20241129","first-page":"253645","article-title":"Xanthogranulomatous cholecystitis masquerading as gallbladder cancer:Can it be diagnosed preoperatively?","author":"Rammohan","year":"2014","journal-title":"Gastroenterol Res Pract 2014"},{"key":"R14-20241129","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1016\/j.gassur.2004.09.036","article-title":"Xanthogranulomatous cholecystitis in laparoscopic surgery","volume":"9","author":"Guzm\u00e1n-Valdivia","year":"2005","journal-title":"J Gastrointest Surg"},{"key":"R15-20241129","doi-asserted-by":"crossref","first-page":"1391","DOI":"10.1016\/j.ejrad.2013.04.026","article-title":"CT and MR features of xanthogranulomatous cholecystitis:An analysis of consecutive 49 cases","volume":"82","author":"Zhao","year":"2013","journal-title":"Eur J Radiol"},{"key":"R16-20241129","doi-asserted-by":"crossref","first-page":"3044","DOI":"10.3760\/cma.j.issn.0366-6999.20120341","article-title":"Tumor biomarkers:Help or mislead in the diagnosis of xanthogranulomatous cholecystitis?Analysis of serum CA 19-9, carcinoembryonic antigen, and CA 12-5","volume":"126","author":"Yu","year":"2013","journal-title":"Chin Med J (Engl)"},{"key":"R17-20241129","doi-asserted-by":"crossref","first-page":"1030","DOI":"10.1002\/bjs.1800810735","article-title":"Xanthogranulomatous cholecystitis","volume":"81","author":"Houston","year":"1994","journal-title":"Br J Surg"},{"key":"R18-20241129","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1007\/s00261-014-0203-0","article-title":"The gallbladder:uncommon gallbladder conditions and unusual presentations of the common gallbladder pathological processes","volume":"40","author":"Revzin","year":"2015","journal-title":"Abdom Imaging"},{"key":"R19-20241129","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1038\/s41572-022-00398-y","article-title":"Gallbladder cancer","volume":"8","author":"Roa","year":"2022","journal-title":"Nat Rev Dis Primers"},{"key":"R20-20241129","doi-asserted-by":"crossref","first-page":"e79","DOI":"10.1016\/j.ejrad.2009.04.017","article-title":"Xanthogranulomatous cholecystitis:Diagnostic performance of CT to differentiate from gallbladder cancer","volume":"74","author":"Goshima","year":"2010","journal-title":"Eur J Radiol"},{"key":"R21-20241129","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1159\/000336985","article-title":"Xanthogranulomatous cholecystitis:Catching the culprit \u2013Clinical and imaging analysis","volume":"29","author":"Jain","year":"2012","journal-title":"Dig Surg"},{"key":"R22-20241129","doi-asserted-by":"crossref","first-page":"1025","DOI":"10.1007\/s11605-007-0181-4","article-title":"A curative resection improves the postoperative survival rate even in patients with advanced gallbladder carcinoma","volume":"11","author":"Kai","year":"2007","journal-title":"J Gastrointest Surg"},{"key":"R23-20241129","doi-asserted-by":"crossref","first-page":"1484","DOI":"10.3390\/jcm9051484","article-title":"Incidental carcinoma after cholecystectomy for benign disease of the gallbladder:A meta-analysis","volume":"9","author":"Pyo","year":"2020","journal-title":"J Clin Med"},{"key":"R24-20241129","doi-asserted-by":"crossref","first-page":"423","DOI":"10.2214\/ajr.179.2.1790423","article-title":"Helical CT of the local spread of carcinoma of the gallbladder:Evaluation according to the TNM system in patients who underwent surgical resection","volume":"179","author":"Yoshimitsu","year":"2002","journal-title":"AJR Am J Roentgenol"},{"key":"R25-20241129","doi-asserted-by":"crossref","first-page":"423","DOI":"10.2214\/ajr.179.2.1790423","article-title":"Helical CT of the local spread of carcinoma of the gallbladder:evaluation according to the TNM system in patients who underwent surgical resection","volume":"179","author":"Yoshimitsu","year":"2002","journal-title":"AJR Am J Roentgenol"},{"key":"R26-20241129","first-page":"504","article-title":"Laparoscopic cholecystectomy can disseminate in situ carcinoma of the gallbladder","volume":"181","author":"Wibbenmeyer","year":"1995","journal-title":"J Am Coll Surg"},{"key":"R27-20241129","doi-asserted-by":"crossref","first-page":"e77","DOI":"10.1016\/j.jviscsurg.2011.02.005","article-title":"Incidentally-discovered gallbladder cancer:When, why and which reoperation?","volume":"148","author":"Isambert","year":"2011","journal-title":"J Visc Surg"},{"key":"R28-20241129","doi-asserted-by":"crossref","first-page":"3","DOI":"10.3126\/kumj.v9i2.6278","article-title":"Incidence of incidental carcinoma gall bladder in cases of routine cholecystectomy","volume":"9","author":"Ghimire","year":"2011","journal-title":"Kathmandu Univ Med J (KUMJ)"},{"key":"R29-20241129","doi-asserted-by":"crossref","first-page":"2503","DOI":"10.4103\/0366-6999.243565","article-title":"Relationship between prognosis and time interval from cholecystectomy to reoperation in postoperative incidental gallbladder carcinoma","volume":"131","author":"Du","year":"2018","journal-title":"Chin Med J (Engl)"}],"container-title":["Journal of Minimal Access Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jmas.jmas_209_24","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:40:40Z","timestamp":1787067640000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jmas.jmas_209_24"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,29]]},"references-count":29,"URL":"https:\/\/doi.org\/10.4103\/jmas.jmas_209_24","relation":{},"ISSN":["0972-9941","1998-3921"],"issn-type":[{"value":"0972-9941","type":"print"},{"value":"1998-3921","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,29]]},"assertion":[{"value":"2024-07-24","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-09-17","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}