Gallbladder pathologies through a decade: Insights into emerging trends and premalignant lesions from a single-center...

Gallbladder diseases, including chronic cholecystitis and cholesterolosis, impose a significant burden on global health. Monitoring their evolving trends is vital to refine diagnostic strategies and improve clinical outcomes. This study evaluates a decade of gallbladder pathology data to identify epidemiological shifts and associated risk factors. This retrospective study analyzed 6665 cholecystectomy specimens from January 2014 to December 2023. Diagnoses included chronic and acute cholecystitis, cholesterolosis, metaplasia, dysplasia, and adenocarcinoma. Annual trends, demographic patterns, and risk factor correlations were examined using advanced statistical analyses, including multivariable logistic regression. Chronic cholecystitis remained the most common diagnosis (87.92%), showing a stable incidence and strong female predominance (4115:1745; P < .001). Cholesterolosis (24.07%) exhibited a rising trend, peaking in 2022, linked to dietary and metabolic changes. Notably, premalignant lesions such as metaplasia (12.54%) and dysplasia (3.11%) increased significantly, with dysplasia peaking in 2022-2023. Adenocarcinoma was rare (0.33%) but strongly correlated with dysplasia (r = 0.186, P < .001). Logistic regression analysis identified age and intestinal metaplasia as independent predictors of dysplasia. For adenocarcinoma, high-grade dysplasia (odds ratio [OR] = 308.9), polyps (OR = 2.9), and intestinal metaplasia (OR = 3.8) emerged as significant risk factors, while chronic cholecystitis (OR = 0.18) and gallstones (OR = 0.31) were independently associated with a reduced risk. The rise in premalignant gallbladder conditions, particularly dysplasia, underscores the importance of routine histopathological examinations following cholecystectomy. Targeted monitoring for high-risk patients and standardized early detection strategies are critical. Future studies should aim to validate these findings in larger, prospective cohorts and investigate the underlying mechanisms-both protective and promotive-by which various histopathological and clinical factors may influence the progression from benign to malignant gallbladder lesions.