Background. Laparoscopic cholecystectomy is considered to be gold standard for symptomatic gall stones. As a routine every specimen is sent for histopathological examination postoperatively. Incidentally finding gall bladder cancers in those specimens is around 0.5–1.1%. The aim of this study is to identify those preoperative and intraoperative factors in patients with incidental gall bladder cancer to reduce unnecessary work load on pathologist and cost of investigation particularly in a developing world. Methods. Retrospective records were analyzed from January 2005 to February 2015 in a surgical unit. Demographic data, preoperative imaging, peroperative findings, macroscopic appearance, and histopathological findings were noted. Gall bladder wall was considered to be thickened if ≥3 mm on preoperative imaging or surgeons comment (on operative findings) and histopathology report. AJCC TNM system was used to stage gall bladder cancer. Results. 973 patients underwent cholecystectomy for symptomatic gallstone disease. Gallbladder carcinoma was incidentally found in 11 cases. Macroscopic abnormalities of the gallbladder were found in all those 11 patients. In patients with a macroscopically normal gallbladder, there were no cases of gallbladder carcinoma. Conclusion. Preoperative and operative findings play a pivotal role in determining incidental chances of gall bladder malignancy.

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Role-play is commonly used as a learning method for teaching communication in medical institutions and there two types of role-play i.e. Round Robin and Relay`s methods. This study among our students and trainers to identify which role-play has better effect on students learning at college of Medicine, King Faisal University, Al Ahsa. All the first year students and trainers were included in the study. Students are divided into different groups and each group contains 9 -11 students. Different scenarios are provided to the students with each physician and patient role. A pre-structured questionnaire was distributed among students and trainers to compare between the Role-play methods. The questionnaire included 15 statements related to the role-play methods based on Likert scale. Wilcoxon signed-rank test was applied to compare different items for both methods and to obtain p-value. The results showed that 221 students and 25 trainers filled the questionnaire. The Round Robin was found to have more influence on students` perception as compared to that for Relay`s except for item 4 i.e. role-play builds a team work where majority of participants agreed for Relay`s method. Similar results were found while checking perception of trainers. The results of statistical test for comparing both methods suggest that there is a significant difference in Round Robin and Relay`s method for most of the questions P-value < 0.05. In this research it is found that both methods of role-play used in communication skills sessions are helpful however, Round robin method has better outcome on learning as compared to Relay`s method.