Introduction: Cholelithiasis is a common condition with significant histopathological consequences for the gallbladder mucosa, ranging from chronic inflammation to potential malignant transformation. This study aimed to assess the spectrum of microscopic changes in gallbladder specimens from cholelithiasis patients and their correlation with clinical parameters.

Materials and Methods: A cross-sectional, observational study was conducted over two years at the Department of Pathology, SubhartiMedical College, Meerut. A total of 100 cholecystectomy specimens from adult patients diagnosed with cholelithiasis were examined. Routine histopathological procedures were employed, and sections were stained with Hematoxylin and Eosin. Additional stains were used when necessary. Findings were correlated with demographic and clinical data, and statistical analysis was performed using SPSS v25.0.

Results: The majority of patients were female (68%), with the highest prevalence in the 41–50 age group. Chronic cholecystitis was observed in 90% of cases, Rokitansky-Aschoff sinuses in 40%, epithelial hyperplasia in 10%, fibrosis/ulceration in 5%, and carcinoma in 2%. Statistically significant associations were found between age and the presence of Rokitansky-Aschoff sinuses (p<0.05). Carcinoma cases occurred exclusively in female patients above 50 years of age.

Conclusions: Chronic inflammatory changes are predominant in gallbladders affected by cholelithiasis. The presence of epithelial hyperplasia and incidental carcinoma emphasizes the necessity for routine histopathological examination of all cholecystectomy specimens to detect early neoplastic changes, particularly in high-risk populations.

Keywords:Cholelithiasis, Gallbladder, Chronic Cholecystitis, Rokitansky-Aschoff Sinuses, Epithelial Hyperplasia, Gallbladder Carcinoma, Histopathology