Pathophysiological significance of gallbladder volume changes in gallstone diseases.
OBJECTIVE
To study the pathophysiological significance of gallbladder volume (GBV) and ejection fraction changes in gallstone patients.


METHODS
The fasting GBV of gallstone patients with acute cholecystitis (n = 99), chronic cholecystitis (n = 85) and non-gallstone disease (n = 240) were measured by preoperative computed tomography. Direct saline injection measurements of GBV after cholecystectomy were also performed. The fasting and postprandial GBV of 65 patients with gallstones and chronic cholecystitis and 53 healthy subjects who received health examinations were measured by abdominal ultrasonography. Proper adjustments were made after the correction factors were calculated by comparing the preoperative and postoperative measurements. Pathological correlations between gallbladder changes in patients with acute calculous cholecystitis and the stages defined by the Tokyo International Consensus Meeting in 2007 were made. Unpaired Student's t tests were used. P < 0.05 was deemed statistically significant.


RESULTS
The fasting GBV was larger in late stage than in early/second stage acute cholecystitis gallbladders (84.66 +/- 26.32 cm(3), n = 12, vs 53.19 +/- 33.80 cm(3), n = 87, P = 0.002). The fasting volume/ejection fraction of gallbladders in chronic cholecystitis were larger/lower than those of normal subjects (28.77 +/- 15.00 cm(3) vs 6.77 +/- 15.75 cm(3), P < 0.0001)/(34.6% +/- 10.6%, n = 65, vs 53.3% +/- 24.9%, n = 53, P < 0.0001).


CONCLUSIONS
GBV increases as acute cholecystitis progresses to gangrene and/or empyema. Gallstone formation is associated with poorer contractility and larger volume in gallbladders that contain stones.
Huang
Shing-Moo
SM
Department and Institute of Biomedical Science, Chung Shan Medical University, No. 110, Sec. 1, Jianguo N. Rd., Taichung 40201, Taiwan, China. shingmooeel@gmail.com
Yao
Chung-Chin
CC
Pan
Huichin
H
Hsiao
Kuang-Ming
KM
Yu
Ji-Kuen
JK
Lai
Te-Jen
TJ
Huang
Shueh-Ding
SD
D000208:Acute Disease; D000328:Adult; D000368:Aged; D002764:Cholecystitis / Q000473:pathology / Q000503:physiopathology; D002908:Chronic Disease; D005260:Female; D005704:Gallbladder / Q000473:pathology* / Q000503:physiopathology; D042882:Gallstones / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009119:Muscle Contraction
J Hepatol. 1992 Mar;14(2-3):194-202
1500683
Gastroenterology. 1988 Aug;95(2):508-23
3292341
Microsc Res Tech. 1997 Oct 1;39(1):71-84
9329020
World J Gastroenterol. 2005 Mar 21;11(11):1685-9
15786550
Nat Med. 2006 Nov;12(11):1253-5
17072310
J Hepatobiliary Pancreat Surg. 2007;14(1):27-34
17252294
Dig Dis Sci. 1989 Mar;34(3):353-9
2920640
Gastroenterology. 1995 Jun;108(6):1882-8
7768394
World J Surg. 2000 Oct;24(10):1278-81
11071475
N Engl J Med. 1980 Feb 14;302(7):362-4
7351927
Eur J Clin Invest. 2000 Apr;30(4):317-24
10759880
Hepatology. 2008 Jun;47(6):2112-26
18506897