Brief Article
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World J Gastroenterol. Sep 14, 2010; 16(34): 4341-4347
Published online Sep 14, 2010. doi: 10.3748/wjg.v16.i34.4341
Pathophysiological significance of gallbladder volume changes in gallstone diseases
Shing-Moo Huang, Chung-Chin Yao, Huichin Pan, Kuang-Ming Hsiao, Ji-Kuen Yu, Te-Jen Lai, Shueh-Ding Huang
Shing-Moo Huang, Chung-Chin Yao, Institute and School of Medicine, Chung Shan Medical University and Division of General Surgery, Department of Surgery, Chung Shan Medical University Hospital, Taichung 40201, Taiwan, China
Huichin Pan, Department and Institute of Biomedical Sciences, Chung Shan Medical University, and Department of Medical Research, Chung Shan Medical University Hospital, Taichung 40201, Taiwan, China
Kuang-Ming Hsiao, Department of Life Science, National Chung Cheng University, Minsyong Township, Chiayi County 621, Taiwan, China
Ji-Kuen Yu, Division of General Surgery, Department of Surgery, Taichung Metroharbor Tung’s Memorial Hospital, Taichung County, Taiwan 435, China
Te-Jen Lai, Institute and School of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan, China
Shueh-Ding Huang, Department of Applied Mathematics, National Chengchi University, Wenshan District, Taipei 116, Taiwan, China
Author contributions: Huang SM, Yao CC and Hsiao KM contributed equally to this work; Huang SM and Pan H designed the study and wrote the manuscript; Yao CC, Yu JK and Lai TJ co-ordinated and provided the collection of data of all the human material, in addition to providing financial support for this work; Hsiao KM and Huang SD provided the statistical analysis and mathematical calculations and were also involved in editing the manuscript.
Supported by Grants from Chung Shan Medical University with Grant Numbers CSMU-TTM-097-001 and CSMU-TTM-098-002
Correspondence to: Huichin Pan, Professor, PhD, Department and Institute of Biomedical Science, Chung Shan Medical University, No. 110, Sec. 1, Jianguo N. Rd., Taichung 40201, Taiwan, China. shingmooeel@gmail.com
Telephone: +886-4-24730022 Fax: +886-4-24757412
Received: April 2, 2010
Revised: May 20, 2010
Accepted: May 27, 2010
Published online: September 14, 2010
Abstract

AIM: 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 cm3, n = 12, vs 53.19 ± 33.80 cm3, 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 cm3vs 6.77 ± 15.75 cm3, P < 0.0001)/(34.6% ± 10.6%, n = 65, vs 53.3% ± 24.9%, n = 53, P < 0.0001).

CONCLUSION: 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.

Keywords: Gallbladder volume; Pathophysiology; Gallbladder ejection fraction; Gallstone formation; Acute cholecystitis