MORPHOLOGICAL CHANGES OF THE GALLBLADDER IN PATIENTS WITH CHRONIC CHOLECYSTITIS AND CHOLESTEROLOSIS DEPENDING ON COMORBID PATHOLOGY: CHD. CARDIOSCLEROSIS AND OBESITY

Abstract

Objective – to study the morphological changes of the gallbladder in patients with chroniccholecystitis and cholesterolosis of the gallbladder depending on comorbid pathologycoronary heart disease (CHD) and obesity. Materials and methods. A retrospective analysis of 300 autopsy protocols of the patientswith obesity, who died from complications of CHD (group A) and 100 protocols ofpathohistological examination of the gallbladder after cholecystectomy for chroniccholecystitis in obese patients (group B) has been carries out. The average age in groupA was 67.3±5.24 years, in group B – 52.8±3.24 years. 157 preparations were studied bythe pathohistological method, for stereometric analysis were selected histopreparationsof 112 cases of autopsy and biopsy of the gallbladder after cholecystectomy. Analysis ofthe morphological state of the gallbladder in patients with I-II degree obesity and CHDwas performed according to the groups.Results. According to autopsy data of deceased patients with CHD. Cardiosclerosiswith obesity of the I-II degree, the morphological features of the lesion of the GB(gallbladder)was comorbidity with chronic cholecystitis: with stones – in 24.3 %, nonstones – in 50.7 % of cases, and xanthogranulomatous cholecystitis was observedin 1.7 % of patients. In 41.7 % of cases, the accompanying cholesterolosis of thegallbladder was determined. Study of the morphological changes of the gallbladderremoved during cholecystectomy in people with CHD. Cardiosclerosis and obesity ofthe I-II degree established the presence of chronic cholecyctitis in 100.0 % of cases:calculous cholecystitis prevailed in 73.0 %, non-calculous cholecystitis accountedfor 20.0 % of cases, and in 7.0 % of patients, xanthogranulomatous cholecystitis wasobserved. In 57.0 % of cases, an accompanying cholesterolosis of the gallbladderwas determined: calculous cholecystitis – 40.0 % and non-calculous cholecystitis – in17.0 % with a predominance of reticular (64.9 %) form of diffuse type (56.1 %), mixed(reticular- polypous) (24.6 %) and polypous forms (10.5 %). Among patients with CHD.Cardiosclerosis and obesity, chronic cholecyctitis is more often observed in women(3.2:1), chronic cholecyctitis with cholesterolosis of the gallbladder – also in women – inthe ratio of men: 2.8:1. Morphological signs of chronic cholecyctitis in patients withCHD and obesity are probable thickening of the gallbladder wall (in the range of 2.6-3.0times (p<0.05)), in case of the concomitant cholesterolosis of the gallbladder – 3.5-3.8times (р<0.05), biliary sludge (100.0 %).Сonclusions. Among patients with coronary heart disease and obesity, chroniccholecystitis and chronic cholecystitis combined with cholesterosis of the gallbladderoccur more often in women (3.2:1 and 2.8:1, respectively). Morphological changes ofgall bladders removed during cholecystectomy in persons with ischemic heart diseaseand obesity of the I-II degree indicate the presence of chronic cholecystitis in 100.0 %of cases.