Histopathologische Veränderungen von Gallenblase und Leberparenchym bei symptomatischer Cholelithiasis

Abstract

In a retrospective study of 1101 patients (302 men, 799 women; mean age 56,7 [19-88] years) with symptomatic cholelithiasis who had undergone elective cholecystectomy and intraoperative liver biopsy, histological examination revealed inflammatory changes in the gallbladder in 96.7%, chronic fibrotic cholecystitis in 94.5% and a severe form of cholecystitis in 8.8%. Clinically relevant changes in the liver parenchyma were present in 27.9%, most frequently intrahepatic cholangitis (21.8%). The latter was significantly more common in choledocholithiasis than in isolated cholecystolithiasis. 27 patients had signs of severe liver disease, namely viral hepatitis, cirrhosis or fatty liver. Since the gall-bladder in cholelithiasis is almost always inflamed, cholecystectomy is the treatment of choice. Not uncommonly liver biopsy will reveal clinically relevant changes in the liver parenchyma. This will be useful information, especially in the management of symptoms which persist postoperatively.

Liver biopsy in gall stone disease: a prospective study in patients undergoing cholecystectomy

“…Intrahepatic cholangitis was found mainly in patients of CBD stone. 20,21 In study of Geraghty 11 out 14 patients had significant liver changes.…”

Association between gallstone-evoked pain, inflammation and proliferation of nerves in the gallbladder: A possible explanation for clinical differences

“…Consequently, chronic inflammation, such as found in up to half of all asymptomatic patients, does not seem to manifest clinical disease. Around 96% of gallbladders with gallstones may show histological signs of chronic inflammation [23] but 33 Á82% of gallbladders without gallstones exhibit similar features [24 Á26]. …”

Chronic Calculus Cholecystitis in the People of Barak Valley in Relation to Sex, Age and Number of Gall Bladder Stones- An Observational Study

“…Chronic Cholecystitis 243 (27%) 657 (73%) 900 [8,9,10,11,12,13,14] The female sex hormones and sedentary lifestyle of Indian women may expose them to factors promoting formation of gallstones. [7,9,15,16,17] Oestrogen is believed to stimulate the HMG-CoA reductase leading to increased synthesis of cholesterol and progesterone is believed to reduce the gallbladder motility promoting bile stasis and concretion.…”