Cholecystosteatosis: An explanation for increased cholecystectomy rates

Hayder H. Al-Azzawi, Attila Nakeeb, Romil Saxena, Mary Maluccio, Henry A. Pitt

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Over the past decade, obesity has become epidemic, and the number of cholecystectomies as well as the percentage with acalculous cholecystitis have increased. We have recently reported that congenitally obese mice and lean mice fed a high fat diet have increased gallbladder wall lipids and poor gallbladder emptying. Therefore, we tested the hypothesis that compared to patients with a normal gallbladder, patients with both acalculous and calculous cholecystitis would have increased gallbladder wall fat. Sixteen patients who underwent cholecystectomy for acalculous cholecystitis were identified. Sixteen nondiseased controls who underwent incidental cholecystectomy during surgery for liver or pancreatic disease and 16 diseased controls whose gallbladder was removed for chronic calculous cholecystitis were chosen to match the acalculous patients for gender and Body Mass Index. Pathology specimens were reviewed in a blinded fashion for gallbladder wall fat, thickness, and inflammation. Acalculous cholecystitis patients were younger (p∈<∈0.01) than nondiseased or diseased controls. Gallbladder wall fat was significantly increased (p∈<∈0.02) in the acalculous and calculous cholecystitis patients compared to the nondiseased controls. Gallbladder wall thickness (p∈<∈0.02) and inflammatory score (p∈<∈0.01) were highest in the calculous cholecystitis patients. These data suggest that compared to nondiseased controls, (1) patients with acalculous cholecystitis are younger and have increased gallbladder fat and (2) patients with calculous cholecystitis have increased gallbladder fat and inflammation. We conclude that increased gallbladder fat may lead to poor gallbladder emptying and biliary symptoms. Thus, cholecystosteatosis may explain, in part, the increased need for cholecystectomy and the higher percentage of these patients with acalculous cholecystitis. .

Original languageEnglish
Pages (from-to)835-843
Number of pages9
JournalJournal of Gastrointestinal Surgery
Volume11
Issue number7
DOIs
StatePublished - Jul 2007

Fingerprint

Cholecystectomy
Acalculous Cholecystitis
Gallbladder
Cholecystitis
Fats
Gallbladder Emptying
Obese Mice
Pancreatic Diseases
High Fat Diet
Liver Diseases
Body Mass Index
Obesity
Pathology
Inflammation
Lipids

Keywords

  • Biliary dyskinesia
  • Cholecystitis
  • Gallstones
  • Obesity
  • Steatosis

ASJC Scopus subject areas

  • Surgery

Cite this

Cholecystosteatosis : An explanation for increased cholecystectomy rates. / Al-Azzawi, Hayder H.; Nakeeb, Attila; Saxena, Romil; Maluccio, Mary; Pitt, Henry A.

In: Journal of Gastrointestinal Surgery, Vol. 11, No. 7, 07.2007, p. 835-843.

Research output: Contribution to journalArticle

Al-Azzawi, Hayder H. ; Nakeeb, Attila ; Saxena, Romil ; Maluccio, Mary ; Pitt, Henry A. / Cholecystosteatosis : An explanation for increased cholecystectomy rates. In: Journal of Gastrointestinal Surgery. 2007 ; Vol. 11, No. 7. pp. 835-843.
@article{83a8e122b5c84403b0e334e374fb237a,
title = "Cholecystosteatosis: An explanation for increased cholecystectomy rates",
abstract = "Over the past decade, obesity has become epidemic, and the number of cholecystectomies as well as the percentage with acalculous cholecystitis have increased. We have recently reported that congenitally obese mice and lean mice fed a high fat diet have increased gallbladder wall lipids and poor gallbladder emptying. Therefore, we tested the hypothesis that compared to patients with a normal gallbladder, patients with both acalculous and calculous cholecystitis would have increased gallbladder wall fat. Sixteen patients who underwent cholecystectomy for acalculous cholecystitis were identified. Sixteen nondiseased controls who underwent incidental cholecystectomy during surgery for liver or pancreatic disease and 16 diseased controls whose gallbladder was removed for chronic calculous cholecystitis were chosen to match the acalculous patients for gender and Body Mass Index. Pathology specimens were reviewed in a blinded fashion for gallbladder wall fat, thickness, and inflammation. Acalculous cholecystitis patients were younger (p∈<∈0.01) than nondiseased or diseased controls. Gallbladder wall fat was significantly increased (p∈<∈0.02) in the acalculous and calculous cholecystitis patients compared to the nondiseased controls. Gallbladder wall thickness (p∈<∈0.02) and inflammatory score (p∈<∈0.01) were highest in the calculous cholecystitis patients. These data suggest that compared to nondiseased controls, (1) patients with acalculous cholecystitis are younger and have increased gallbladder fat and (2) patients with calculous cholecystitis have increased gallbladder fat and inflammation. We conclude that increased gallbladder fat may lead to poor gallbladder emptying and biliary symptoms. Thus, cholecystosteatosis may explain, in part, the increased need for cholecystectomy and the higher percentage of these patients with acalculous cholecystitis. .",
keywords = "Biliary dyskinesia, Cholecystitis, Gallstones, Obesity, Steatosis",
author = "Al-Azzawi, {Hayder H.} and Attila Nakeeb and Romil Saxena and Mary Maluccio and Pitt, {Henry A.}",
year = "2007",
month = "7",
doi = "10.1007/s11605-007-0169-0",
language = "English",
volume = "11",
pages = "835--843",
journal = "Journal of Gastrointestinal Surgery",
issn = "1091-255X",
publisher = "Springer New York",
number = "7",

}

TY - JOUR

T1 - Cholecystosteatosis

T2 - An explanation for increased cholecystectomy rates

AU - Al-Azzawi, Hayder H.

AU - Nakeeb, Attila

AU - Saxena, Romil

AU - Maluccio, Mary

AU - Pitt, Henry A.

PY - 2007/7

Y1 - 2007/7

N2 - Over the past decade, obesity has become epidemic, and the number of cholecystectomies as well as the percentage with acalculous cholecystitis have increased. We have recently reported that congenitally obese mice and lean mice fed a high fat diet have increased gallbladder wall lipids and poor gallbladder emptying. Therefore, we tested the hypothesis that compared to patients with a normal gallbladder, patients with both acalculous and calculous cholecystitis would have increased gallbladder wall fat. Sixteen patients who underwent cholecystectomy for acalculous cholecystitis were identified. Sixteen nondiseased controls who underwent incidental cholecystectomy during surgery for liver or pancreatic disease and 16 diseased controls whose gallbladder was removed for chronic calculous cholecystitis were chosen to match the acalculous patients for gender and Body Mass Index. Pathology specimens were reviewed in a blinded fashion for gallbladder wall fat, thickness, and inflammation. Acalculous cholecystitis patients were younger (p∈<∈0.01) than nondiseased or diseased controls. Gallbladder wall fat was significantly increased (p∈<∈0.02) in the acalculous and calculous cholecystitis patients compared to the nondiseased controls. Gallbladder wall thickness (p∈<∈0.02) and inflammatory score (p∈<∈0.01) were highest in the calculous cholecystitis patients. These data suggest that compared to nondiseased controls, (1) patients with acalculous cholecystitis are younger and have increased gallbladder fat and (2) patients with calculous cholecystitis have increased gallbladder fat and inflammation. We conclude that increased gallbladder fat may lead to poor gallbladder emptying and biliary symptoms. Thus, cholecystosteatosis may explain, in part, the increased need for cholecystectomy and the higher percentage of these patients with acalculous cholecystitis. .

AB - Over the past decade, obesity has become epidemic, and the number of cholecystectomies as well as the percentage with acalculous cholecystitis have increased. We have recently reported that congenitally obese mice and lean mice fed a high fat diet have increased gallbladder wall lipids and poor gallbladder emptying. Therefore, we tested the hypothesis that compared to patients with a normal gallbladder, patients with both acalculous and calculous cholecystitis would have increased gallbladder wall fat. Sixteen patients who underwent cholecystectomy for acalculous cholecystitis were identified. Sixteen nondiseased controls who underwent incidental cholecystectomy during surgery for liver or pancreatic disease and 16 diseased controls whose gallbladder was removed for chronic calculous cholecystitis were chosen to match the acalculous patients for gender and Body Mass Index. Pathology specimens were reviewed in a blinded fashion for gallbladder wall fat, thickness, and inflammation. Acalculous cholecystitis patients were younger (p∈<∈0.01) than nondiseased or diseased controls. Gallbladder wall fat was significantly increased (p∈<∈0.02) in the acalculous and calculous cholecystitis patients compared to the nondiseased controls. Gallbladder wall thickness (p∈<∈0.02) and inflammatory score (p∈<∈0.01) were highest in the calculous cholecystitis patients. These data suggest that compared to nondiseased controls, (1) patients with acalculous cholecystitis are younger and have increased gallbladder fat and (2) patients with calculous cholecystitis have increased gallbladder fat and inflammation. We conclude that increased gallbladder fat may lead to poor gallbladder emptying and biliary symptoms. Thus, cholecystosteatosis may explain, in part, the increased need for cholecystectomy and the higher percentage of these patients with acalculous cholecystitis. .

KW - Biliary dyskinesia

KW - Cholecystitis

KW - Gallstones

KW - Obesity

KW - Steatosis

UR - http://www.scopus.com/inward/record.url?scp=34347219152&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=34347219152&partnerID=8YFLogxK

U2 - 10.1007/s11605-007-0169-0

DO - 10.1007/s11605-007-0169-0

M3 - Article

C2 - 17458589

AN - SCOPUS:34347219152

VL - 11

SP - 835

EP - 843

JO - Journal of Gastrointestinal Surgery

JF - Journal of Gastrointestinal Surgery

SN - 1091-255X

IS - 7

ER -