Gallbladder cholesterolosis in patients with metabolic syndrome and chronic pancreatitis

Abstract

Cholesterolosis, as a pathological condition caused by metabolic disorders, is potentially associated with metabolic syndrome and chronic pancreatitis. The aim of the study was to assess the prevalence and morphological features of gallbladder cholesterolosis in the contingent of patients with metabolic syndrome and chronic pancreatitis. 82 patients who underwent cholecystectomy for chronic calculous cholecystitis were included in our study. The experimental group consisted of 37 patients with metabolic syndrome and chronic pancreatitis. The comparison group included 45 patients without clinically confirmed metabolic syndrome and chronic pancreatitis. In accordance with the purpose and objectives, morphological examination of the gallbladder wall was performed. Data to be analyzed were processed using the statistical software package SPSS 20.0 for Windows. The gender and age structure of the studied contingent did not differ from that described in the scientific literature. The morphological picture of cholesterolosis did not differ in the study groups. In a mucous membrane considerable polymorphism of folds (villi) was noted. There were signs of desquamation and regeneration in the epithelium. There was a violation of the structure Rokitansky-Aschoff sinuses. In some crypts microconcretions were defined. Atrophy and sclerosis of the stroma of the villi were detected in the mucous membrane. Significant expansion of the lumen of the veins in the own plate of the mucous membrane and the perimuscular layer of the gallbladder wall was noteworthy. Signs of stasis were found in the lumen of blood vessels. The lumen of the arteries was narrowed in places due to swelling and accumulation of yellow-brown pigment. Signs of spasm and significant sclerosis of the wall were identified. Dystrophic changes in the endothelium contribute not only to the development of uneven plethora of stagnant nature with significant edema, but also hemorrhage. Significant swelling of all layers was characteristic, causing their disintegration. Significant dilation of lymphatic vessels causes a significant thickening of the gallbladder wall. In some places, there is uneven hypertrophy of the muscle layer. There was an excessive increase in the tortuosity ducts of Luschka. According to the study, patients with metabolic syndrome and chronic pancreatitis, operated on for chronic calculous cholecystitis, along with maintaining the gender and age structure of the contingent, there is a significantly higher incidence of gallbladder cholesterolosis.