Risk Factors For Gallstones Research Articles

Risk Factors for Gallstones in Crohn's Disease: A Systematic Review and Meta-Analysis.

Crohn's disease (CD) have an increased risk of gallstone disease. We aimed to systematically evaluate the prevalence rate and relevant risk factors of gallstones in CD patients. A comprehensive search of PubMed, Embase, and Web of Science databases from inception to September 10, 2023, identified studies investigating risk factors for gallstone development among CD patients. Gender, age, body mass index, disease duration, disease site, stenosis, prior surgery, hospitalization times, corticosteroids, immunomodulators, and total parenteral nutrition (TPN) were assessed as potential risk factors. Odds ratios (OR) and confidence intervals (CI) were calculated. Among 1184 articles, 11 observational studies (3588 patients) were included. The prevalence of CD patients with gallstones was approximately 14.7%. Factors significantly associated with increased gallstone risk included Age ≥ 40years old (OR 3.06, 95% CI 2.09- 4.48), disease duration > 15years (OR 3.01, 95% CI 2.06-4.42), lifetime surgery(OR 2.50, 95% CI 1.99-3.12), disease located in ileocolon (OR 1.38, 95% CI 1.04-1.83) and ileocecal(OR 1.93, 95% CI 1.16-3.21), multiple hospitalizations(OR 4.26, 95% CI 2.43-7.46), corticosteroid treatments(OR 2.65, 95% CI 1.52-4.63), immunomodulator therapy(OR 1.94, 95% CI 1.12-3.38), and TPN use(OR 2.66, 95% CI 1.29-5.51). Sex, stenosis, overweight, or low weight did not significantly increase the risk of gallstone developing. Age, long disease duration, specific disease locations (ileocolon, ileocecal), surgery, number of hospitalizations, corticosteroids, immunomodulator therapy, and TPN were identified as factors that increased the risk of gallstones in CD patients. About 14.7% of CD patients experience gallstones, so raising awareness and implementing prevention are needed. PROSPERO (CRD42023449299).

Synergy of gut microbiome and bile acids in inducing cholelithiasis

Gallstones have remained an expensive and crippling social problem in public health. The pathophysiology of cholelithiasis is not well understood and involves several variables. Even though, the risk factors for gallstones and other metabolic syndrome are considered to be similar but there is a long list of risk factors associated with lithogenecity such as age, parity and obesity. In addition to all this, intricate relationships between the microecology of the gastrointestinal tract and lithogenesis has been highlighted in this context.The gut microbiome and metabolism of bile acids are deeply interwoven. The pathways that regulate the conversion of cholesterol into bile acids in the hepatocytes to promote the digestion and to acts as an antimicrobial surfactant in the gastrointestinal tract is well understood. Nevertheless, the gut microecosystem further augments the biotransformation in the enteric region via three mechanisms: dehydroxylation, deconjugation and epimerization. By the virtue of these mechanisms the gut microbiota regulates the bile acid pool by biotransforming primary bile acids into secondary bile acids. The primary bile salt diversifies gut microbiome and maintains microbial lineage, whereas secondary bile salt perpetuate it.Therefore, it is not wrong to suggest that changes in the microbiome-bile salt equilibrium may contribute to the hepatic and gastrointestinal disorders like cholelithiasis, specifically gallbladder stones, choledocholithiasis, and asymptomatic gallstones.Thus, this review serve as a backbone in explaining the entangled connection of bile acid composition-gut microbiome-host’s health.

Advancements in Cholelithiasis Diagnosis: A Systematic Review of Machine Learning Applications in Imaging Analysis.

Gallstone disease is a common condition affecting a substantial number of individuals globally. The risk factors for gallstones include obesity, rapid weight loss, diabetes, and genetic predisposition. Gallstones can lead to serious complications such as calculous cholecystitis, cholangitis, biliary pancreatitis, and an increased risk for gallbladder (GB) cancer. Abdominal ultrasound (US) is the primary diagnostic method due to its affordability and high sensitivity, while computed tomography (CT) and magnetic resonance cholangiopancreatography (MRCP) offer higher sensitivity and specificity. This review assesses the diagnostic accuracy of machine learning (ML) technologies in detecting gallstones. This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for reporting systematic reviews and meta-analyses. An electronic search was conducted in PubMed, Cochrane Library, Scopus, and Embase, covering literature up to April 2024, focusing on human studies, and including all relevant keywords. Various Boolean operators and Medical Subject Heading (MeSH) terms were used. Additionally, reference lists were manually screened. The review included all study designs and performance indicators but excluded studies not involving artificial intelligence (AI)/ML algorithms, non-imaging diagnostic modalities, microscopic images, other diseases, editorials, commentaries, reviews, and studies with incomplete data. Data extraction covered study characteristics, imaging modalities, ML architectures, training/testing/validation, performance metrics, reference standards, and reported advantages and drawbacks of the diagnostic models. The electronic search yielded 1,002 records, of which 34 underwent full-text screening, resulting in the inclusion of seven studies. An additional study identified through citation searching brought the total to eight articles. Most studies employed a retrospective cross-sectional design, except for one prospective study. Imaging modalities included ultrasonography (four studies), computed tomography (three studies), and magnetic resonance cholangiopancreatography (one study). Patient numbers ranged from 60 to 2,386, and image numbers ranged from 60 to 17,560 images included in the training, validation, and testing of the diagnostic models. All studies utilized neural networks, predominantly convolutional neural networks (CNNs). Expert radiologists served as the reference standard for image labelling, and model performances were compared against human doctors or other algorithms. Performance indicators such as sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were commonly used. In conclusion, while the reviewed machine learning models show promising performance in diagnosing gallstones, significant work remains to be done to ensure their reliability and generalizability across diverse clinical settings. The potential for these models to improve diagnostic accuracy and efficiency is evident, but the careful consideration of their limitations and rigorous validation are essential steps toward their successful integration into clinical practice.

Association between nonalcoholic fatty liver disease and gallstone risk in nonobese and lean individuals.

The association between nonobese/lean nonalcoholic fatty liver disease (NAFLD) and gallstone formation remains unclear. We aimed to assess whether NAFLD is an independent risk factor for gallstones, even in nonobese or lean individuals. We analyzed 265 353 asymptomatic adults who underwent abdominal ultrasonography. The risk of gallstone was assessed on the basis of obesity and NAFLD status. The overall prevalence rates of NAFLD and gallstones were 27.1% and 2.6%, respectively. The prevalence rates of NAFLD among the 195 204 nonobese and 136 194 lean participants were 14.7% and 7.4%, respectively. Individuals with NAFLD had a significantly increased risk of gallstones (adjusted odds ratio [OR], 1.23; 95% confidence interval [CI], 1.14-1.32). Moreover, NAFLD significantly increased the risk of gallstone (adjusted OR, 1.29; 95% CI, 1.17-1.41) among nonobese individuals. Lean individuals with NAFLD also exhibited a significantly increased risk of gallstones (adjusted OR, 1.20; 95% CI, 1.03-1.40). Furthermore, these findings remained consistent even in nonobese and lean individuals without insulin resistance. Nonobese/lean NAFLD is an independent risk factor for gallstone formation, suggesting its role in gallstone pathogenesis, regardless of obesity status. Therefore, when hepatic steatosis is detected on abdominal ultrasonography, a more thorough evaluation of the gallstones may be necessary, even in nonobese or lean individuals.

The Association Between Cotinine-Verified Smoking Status and Risk of Gallstones: A Cohort Study.

Previous epidemiological data on the association between cigarette smoking and risk of gallstone development remain controversial, and most relevant studies have relied on self-reported questionnaires. We aimed to elucidate this association using both an objective biomarker of tobacco exposure (urinary cotinine) and a self-reported questionnaire. We analyzed 221,721 asymptomatic adults who underwent abdominal ultrasonography and urinary cotinine measurement between January 2011 and December 2016. Cotinine-verified current smokers were defined as participants with urinary cotinine levels ≥50 ng/mL. The mean age of the study population was 35.9 years, and the proportion of men was 55.8%. The proportions of self-reported and cotinine-verified current smokers were 21.3% and 21.2%, respectively. After adjusting for confounding factors, self-reported current smoking was associated with an increased risk of gallstone development [adjusted odds ratio (aOR) 1.14; 95% confidence interval (95%CI), 1.04-1.25]. Moreover, among the current smokers, the risk of gallstone development increased with an increase in the amount of cigarette smoking (<20 and ≥20 pack-years vs. never smoked; aOR=1.11 and 1.25; 95%CI: 1.01-1.22 and 1.07-1.45, respectively). Cotinine-verified current smoking was also associated with an increased risk of gallstone development (aOR=1.16; 95%CI: 1.07-1.25). Among the self-reported never or former smokers, the cotinine-verified current smokers (aOR=1.20; 95%CI: 1.01-1.44) showed a significantly higher risk of gallstones than cotinine-verified never smokers. Cotinine-verified and self-reported current smoking were independent risk factors for gallstones, suggesting a distinct role of tobacco smoking in gallstone development.

Classification of anatomical morphology of cystic duct and its association with gallstone.

Gallstones are common lesions that often require surgical intervention. Laparoscopic cholecystectomy is the treatment of choice for symptomatic gallstones. Preoperatively, the anatomical morphology of the cystic duct (CD), needs to be accurately recognized, especially when anatomical variations occur in the CD, which is otherwise prone to bile duct injury. However, at present, there is no optimal classification system for CD morphology applicable in clinical practice, and the relationship between anatomical variations in CDs and gallstones remains to be explored. To create a more comprehensive clinically applicable classification of the morphology of CD and to explore the correlations between anatomic variants of CD and gallstones. A total of 300 patients were retrospectively enrolled from October 2021 to January 2022. The patients were divided into two groups: The gallstone group and the nongallstone group. Relevant clinical data and anatomical data of the CD based on magnetic resonance cholangiopancreatography (MRCP) were collected and analyzed to propose a morphological classification system of the CD and to explore its relationship with gallstones. Multivariate analysis was performed using logistic regression analyses to identify the independent risk factors using variables that were significant in the univariate analysis. Of the 300 patients enrolled in this study, 200 (66.7%) had gallstones. The mean age was 48.10 ± 13.30 years, 142 (47.3%) were male, and 158 (52.7%) were female. A total of 55.7% of the patients had a body mass index (BMI) ≥ 24 kg/m2. Based on the MRCP, the CD anatomical typology is divided into four types: Type I: Linear, type II: n-shaped, type III: S-shaped, and type IV: W-shaped. Univariate analysis revealed differences between the gallstone and nongallstone groups in relation to sex, BMI, cholesterol, triglycerides, morphology of CD, site of CD insertion into the extrahepatic bile duct, length of CD, and angle between the common hepatic duct and CD. According to the multivariate analysis, female, BMI (≥ 24 kg/m2), and CD morphology [n-shaped: Odds ratio (OR) = 10.97, 95% confidence interval (95%CI): 5.22-23.07, P < 0.001; S-shaped: OR = 4.43, 95%CI: 1.64-11.95, P = 0.003; W-shaped: OR = 7.74, 95%CI: 1.88-31.78, P = 0.005] were significantly associated with gallstones. The present study details the morphological variation in the CD and confirms that CD tortuosity is an independent risk factor for gallstones.

High incidence of gallstones after Roux-en-Y reconstruction gastrectomy in gastric cancer: a multicenter, long-term cohort study.

Roux-en-Y reconstruction is a common anastomosis technique during gastrectomy in gastric cancer. There is a lack of studies on gallstones after Roux-en-Y reconstruction gastrectomy. This study investigated the incidence and potential risk factors associated with gallstones after Roux-en-Y reconstructive gastrectomy in gastric cancer. The study analyzed data from gastric cancer who underwent radical gastrectomy and Roux-en-Y reconstruction at two hospitals between January 2014 and December 2020. The patients fall into distal and total gastrectomy groups based on the extent of gastrectomy. The cumulative event probability curve was plotted using the Kaplan-Meier, and differences in gallstone between groups were evaluated using the Log-Rank. Propensity score matching was applied to construct a balanced total versus distal gastrectomies cohort. A Cox regression was employed to analyze the risk factors for gallstones after Roux-en-Y reconstructive gastrectomy in gastric cancer. Further subgroup analysis was performed. Five hundred thirty-one patients were included in this study, 201 in the distal gastrectomy group and 330 in the total gastrectomy. During the follow-up, gallstones occurred in 170 cases after gastrectomy, of which 145 cases accounted for 85.29% of all stones in the first two years after surgery. Then, to reduce the impact of bias, a 1:1 propensity score matching analysis was performed on the two groups of patients. A total of 344 patients were evaluated, with each subgroup comprising 172 patients. In the matched population, the Cox regression analysis revealed that females, BMI ≥23kg/m 2 , total gastrectomy, No.12 lymph node dissection, and adjuvant chemotherapy were risk factors for gallstones after Roux-en-Y reconstructive gastrectomy. Subgroup analysis showed that open surgery further increased the risk of gallstones after total gastrectomy. The incidence of gallstones increased significantly within 2years after Roux-en-Y reconstructive gastrectomy for gastric cancer. Patients with these risk factors should be followed closely after gastrectomy to avoid symptomatic gallstones.

Lipid accumulation product and gallstone risk in US adults: A cross-sectional analysis of NHANES 2017-2020 data.

Abdominal obesity and insulin resistance are key risk factors for gallstones. The Lipid Accumulation Product (LAP), which combines waist circumference and triglyceride levels, may be a superior marker for visceral fat accumulation. However, its association with gallstone risk is unclear. Data from 3294 participants in the National Health and Nutrition Examination Survey (NHANES) 2017-2020 cycle were analyzed. Weighted logistic regression, subgroup analyses, and restricted cubic spline (RCS) analysis explored the relationship between LAP and gallstone risk. ROC analysis, along with Random Forest and CatBoost models, compared the predictive abilities of LAP with BMI. Weighted logistic regression analysis showed that each unit increase in Ln-LAP was associated with a 52% higher risk of gallstones (OR: 1.52; 95% CI: 1.24-1.86; P = 0.009). Compared to the lowest tertile (T1), the second tertile (T2) had a higher risk of gallstones (OR: 1.76; 95% CI: 1.09-2.84; P = 0.082), and the third tertile (T3) had an even higher risk (OR: 2.27; 95% CI: 1.47-3.49; P = 0.021). RCS analysis showed a nonlinear positive relationship between Ln-LAP and gallstone risk (non-linear P < 0.001). Subgroup analyses indicated that Ln-LAP was significantly positively associated with the risk of gallstones in most subgroups, with no significant interactions observed among the subgroups. Weighted logistic regression analysis revealed a significant positive association between BMI ≥ 30 kg/m2 (obesity) and the risk of gallstones. ROC analysis indicated that Ln-BMI is a better predictor of gallstone risk than Ln-LAP. However, in Random Forest and CatBoost models, LAP exhibited predictive value similar to BMI for gallstone risk. While LAP is significantly and positively associated with an increased risk of gallstones, BMI generally appears to be a stronger predictor. However, LAP may still serve as a comparable marker under specific modeling conditions. Further research is needed to explore the relationship between LAP and gallstone risk.

The Potential of Herbal Management in Gallstone (Pittashmari) – A Case Study

In India, cholelithiasis (gallstones) is now the leading problem. Some patients have a single gallstone, while others develop multiple gallstones at the same time. It could be as big as a golf ball or as small as a grain of sand. The risk factors for gallstones include middle age, inconsistent eating patterns, extended fasting, and metabolic syndrome. Surgical treatment is usually required, such as the removal of the entire gall bladder (cholecystectomy). In Ayurveda, it is not texted directly. There is a description of ashmari (urinary calculi), so by considering the symptoms and pathology of cholelithiasis, it can be correlated with pittashmari, as that site was given for Accha pitta according to the Ayurvedic classics. Pittashamri pathophysiology includes kapha-pitta vitiation and an obstructed Vayu marga (path). A 40-year-old male patient complained of pain in the upper abdomen along with bloating, chest discomfort, and constipation for the past 6 months. The patient had been taking modern medications. But patient experienced only temporary relief of symptoms. So, the patient came to the OPD for Ayurvedic treatment. Investigating with ultrasound, the patient was diagnosed with cholelithiasis and treated purely with herbal drugs as the patient was unaffordable. Pittarechaka (cholagogue), yakruta-pleehaghna, ashmarighna, and drugs with choleretic properties, such as kokilaksha, haritaki, bhumyamalaki, and rohitakarishta, were chosen. Within 15 days, the patient’s symptoms had significantly improved. The Numerical Rating Scale (NRS) was used to assess abdominal pain. A reduction in the size of the gallstone was seen within three months, and a completely normal ultrasound after one year, as discussed here.

RISK FACTORS OF GALLBLADDER STONE IN LADY READING HOSPITAL PESHAWAR, PAKISTAN

Gallbladder stones are a prevalent and expensive cause of gastroenterological problems in the surgical units and OPD patients at the Lead Reading Hospital in Peshawar. Identifying the risk factors of gallstones is essential to reduce the economic burden and life-threatening complications associated with this condition. The aim of this cross-sectional observational study was to determine the major causes and risk factors of gallbladder stones disease, the association with age, and the frequency of gallbladder stones among male and female participants admitted in the surgical unit and radiology department of the hospital. A sample size of 220 participants was collected from a total population of 1000 people in the specified period of time. Data was collected from patients’ detailed history, signs, symptoms, and ultrasound reports over a six-month duration. After data collection and analysis, it was found that women had a twofold higher risk for cholelithiasis or gallstones compared to men. Age, body mass index, and high serum HDL cholesterol levels were independently associated with cholelithiasis in both men and women. In the male population, low alcohol and high coffee consumption were also associated with cholelithiasis. The major risk factors of gallbladder stones were obesity, increased BMI, age, diabetes mellitus, alcohol, smoking, HCV, cirrhosis of the liver, high cholesterol, infection, and cirrhosis in both genders, and menopause in females. The study identified that there were no unique causes or risk factors of gallbladder stones among the study of Asian versus western population.

The association between blood heavy metals and gallstones: A cross-sectional study

Background and aimsExposure to heavy metals has been widely recognized as a risk factor for human health. However, there is limited information on the effects of blood heavy metals on gallstones. This study aims to investigate the relationship between blood heavy metals and gallstones using data from the National Health and Nutrition Examination Survey (NHANES). Methods7192 participants aged 20 years or older with complete information were included in the study. Serum concentrations of heavy metals were determined by inductively coupled plasma kinetic reaction cell mass spectrometry. Gallstones were presented by standard questionnaires. Logistic regression, nonlinear, subgroup, and sensitivity analyses were used to estimate the association between blood heavy metals and gallstones. ResultsMultivariate logistic regression showed that the highest quintile of blood selenium (Se) was associated with a higher risk of gallstones compared with the lowest quintile (OR = 1.66, 95% CI: 1.16–2.36), particularly in individuals who were under 65 years of age, females, non-Hispanic Whites, non-drinkers, obese, and had a college education or higher. There was no correlation between blood cadmium (Cd), mercury (Hg), lead (Pb), manganese (Mn), and gallstones in the total population. Restricted cubic spline curves showed that a negative correlation was observed between blood Cd (OR = 0.84, 95% CI: 0.710–1.00), Hg (OR = 0.87, 95% CI: 0.78–0.97) and gallstones when Cd < 0.302 μg/L and Hg < 3.160 μg/L. ConclusionsBlood Se was an independent risk factor for gallstones, particularly in individuals under 65 years old, females, non-Hispanic Whites, non-drinkers, obese, and had a college education or higher. Furthermore, blood Cd and Hg were associated with a reduced risk of gallstones within a certain range.

A study of H. pylori infection as risk factor for the gall stone disease

Background: Gallstones are one of the widely occurring digestive/hepatobiliary disorders. Chronic cholecystitis, cholelithiasis or symptomatic gallbladder is a prolonged mechanical or functional disorder of abnormal gallbladder emptying. Nearly eighty percent of the gallstones are cholesterol gallstones, and 20% are pigmented stones consisting of bilirubin and calcium, the two components present in the bile. The diagnosis is established by a variety of diagnostic tools like ultrasonography, CT scan, ERCP, liver function tests and pancreatic enzyme studies. The hypothesis of the presence of H. pylori in the biliary epithelium of the patients with hepatobiliary ailments has been sporadically investigated. Helicobacter pylori (H. pylori) is a spiral, microaerophilic, gram-negative bacterium. There are many suggestive evidences that the DNA components of H. pylori is found in the bile, gallbladder tissue and/or cholesterol gallstones. The association of gallstones with Helicobacter pylori has been investigated by many authors, but not clearly established. Methods: The present study is aimed to identify the Helicobacter pylori infection as a risk factor for gallstone disease. The histopathological samples of gall bladder mucosa were examined by staining with modified giemsa stain, haematoxylin, and eosin. Results: Our study showed the presence of H. pylori in only one case which is not statistically significant. Moreover, the present study was based on H and E stains only and they should have been substantiated with immunohistochemistry and PCR studies. Thus, further studies are required to establish a causal relationship between the Helicobactor pylori infection and gallstone formation. Conclusions: Helicobacter pylori as a risk factor for gallstones is yet to be proven.

Association between metabolically healthy overweight/obesity and gallstones in Chinese adults

BackgroundMetabolic syndrome and obesity are risk factors for gallstones. However, these two factors often occur together, and few studies have focused on the association between metabolically healthy overweight/obesity (MHOW/MHO) and gallstones. We hypothesized that MHO individuals would be associated with the prevalence of gallstones.MethodsThis cross-sectional study included 125,668 participants aged 18–80 years at the Health Promotion Center of Run Run Run Shaw Hospital, Zhejiang University School of Medicine during 2017–2019 years. Each participant underwent a comprehensive health checkup. Gallstones were diagnosed by abdominal ultrasonography. Metabolically health was defined as not meeting the diagnostic criteria for metabolic syndrome (MetS). Obesity was measured by BMI. MetS and weight stratification were combined to classify the metabolism-obesity phenotypes. Logistic regression models were used to estimate adjusted odds ratios (ORs) and 95% CIs.ResultsAmong 125,668 participants, 5486 (4.4%) had gallstones. 21407 (17.0%) were MHOW individuals, and 3322 (2.6%) were MHO individuals. MHOW (OR 1.40; 95%CI: 1.29–1.53) and MHO (OR 1.80; 95%CI: 1.53–2.12) participants were at higher risk of gallstones and had larger and more numerous gallstones than metabolically healthy normal weight participants. Obesity, MetS, premenopausal women and advanced age were significantly associated with the prevalence of gallstones.ConclusionsMHOW/MHO individuals exhibited a higher risk of gallstones. In metabolically healthy individuals, the risk of gallstones increased with increasing BMI. Thus, obesity was associated with the prevalence of gallstones, even in relatively metabolically healthy adults.

Analysis of risk factors for the increased incidence of gallstone caused by hepatectomy: A retrospective case-control study.

An increased risk of gallstones has been observed in patients undergoing hepatectomy. This study attempted to analyze the risk factors for gallstones after hepatectomy. From January 2013 to December 2016, clinical data of 1,452 eligible patients who underwent hepatectomy were consecutively reviewed. According to the imaging, including gallbladder ultrasound, computerized tomography, and magnetic resonance imaging, all patients were divided into the gallstone group and the nongallstone group. Univariate and multivariate logistic regression analyses were performed to select indicators associated with gallstone formation among patients after hepatectomy. In the total sample of included patients, there were 341 patients with gallstones and 1,147 patients without gallstones. The incidence of gallstones was 23.5% (341/1,452). The incidence of gallstones in the primary liver cancer group was higher than that in the benign liver tumor group (25.7% vs. 18.9%, P = 0.004). Univariate and multivariate logistic regression analyses showed that female gender, high body mass index, tumor located in S5, and severe postoperative complication were factors related to gallstones in patients with benign liver tumors after hepatectomy. In addition, Child-Pugh B, low albumin, liver cirrhosis, and transcatheter arterial chemoembolization (TACE) after recurrence were factors related to gallstones in patients with primary liver cancer after hepatectomy. Hepatectomy increased the risk of gallstones in benign or malignant liver tumors, especially when the tumor was located in S5. TACE further increased the risk of gallstones in patients with postoperative recurrence.

Debunking Old Beliefs: Endoscopic Retrograde Cholangiopancreatography in Pregnancy

Pregnancy is a state associated with an increased risk of lithogenesis on the gallbladder. Cholelithiasis during pregnancy has an incidence of 12%, with pregnancy being an important risk factor for gallstones. The delayed endoscopic intervention has been associated with an increased risk of adverse events. Using the resource of ERCP in pregnancy is valuable in diseases of the biliary tract. The use of measures to reduce exposure to radiation should be the norm and the delay of this procedure should not be carried out when there are precise indications for it.

The effect of the COVID-19 pandemic period on the cases of acute cholecystitis

Aim: A gallstone is a stone formed within the gallbladder out of precipitated bile components. Risk factors for gallstones include a family history of gallstones, age, genetic and environmental factors, sedentary lifestyle, high-fat diet, obesity. In this study, it was aimed to determine the effects of the pandemic process on acute cholecystitis cases.&#x0D; Material and Method: Patients who applied to hospital between 1st January 2018 and 1st January 2022 and were diagnosed with Acute Cholecystitis were retrospectively screened. The demographic data as age and sex were recorded by dividing the patients into two groups, two years before and two years after the COVID-19 pandemic period.&#x0D; Results: The 2-year retrospective evaluation before and after the COVID-19 pandemic, a significant increase was found in cases of acute cholecystitis after the pandemic (p

Important risk factors for gallstones after laparoscopic gastrectomy: a retrospective study

BackgroundThe frequency of gallstones is higher in patients who have undergone gastrectomy than in the general population. While there have been some studies of gallstone formation after open gastrectomy, there are few reports of gallstones after laparoscopic gastrectomy (LG). Therefore, this study aimed to evaluate the incidence of gallstones after LG.MethodsWe retrospectively reviewed the records of 184 patients who underwent LG between January 2011 and May 2016 at Saiseikai Utsunomiya Hospital. After gastrectomy, abdominal ultrasonography was generally performed every 6 months for 5 years. Patients who underwent cholecystectomy before LG, underwent simultaneous cholecystectomy, and did not undergo abdominal ultrasonography, with an observation period of < 24 months, were excluded from the study. Finally, 90 patients were analyzed. Laparoscopic cholecystectomy was performed whenever biliary complications occurred. Patient characteristics were compared using the two-tailed Fisher’s exact test or Chi-square test. In addition, the risk factors for postoperative gallstones were analyzed using logistic regression analysis.ResultsAmong the 90 patients included in this study, 60 were men (78%), and the mean age was 65.5 years. Laparoscopic total gastrectomy was performed for 15 patients and laparoscopic distal gastrectomy for 75 patients. D2 lymph node dissection was performed for 8 patients (9%), whereas 68 patients underwent LG with Roux-en-Y reconstruction (76%). Gallstones were detected after LG in 27 of the 90 (30%) patients. Multivariate analysis identified Roux-en-Y reconstruction and male sex as significant risk factors of gallstones after gastrectomy. The incidence of gallstones was significantly higher (53%) in male patients who underwent Roux-en-Y reconstruction. Symptomatic gallstones after laparoscopic cholecystectomy were found in 6 cases (6/27, 22%), and all patients underwent laparoscopic cholecystectomy.ConclusionRoux-en-Y reconstruction and male sex were identified as significant risk factors for gallstones after LG.

Comparison of Body Mass Index and Cholelithiasis Diagnosed on Ultrasound in the Population of Pindi Bhattian

Obesity is one of the emerging conditions in our population. Gallstones are composed of cholesterol. It is postulated that gallstones are associated with the deposition of cholesterol. Ultrasound is the first line imaging modality for the diagnosis of cholelithiasis. If gallstones are correlated with BMI, it will open up a new vista for further research. In Yaqoob Ultrasound Clinic, PindiBhattian, Pakistan, a cross sectional analytical study was conducted. All included patients were inquired regarding variables like Age, Height, Weight, Presences of stones, Wall thickness of gall bladder, and location of gall stones on grey scale ultrasound findings. Patients were asked to lie down and expose their abdomen; grey scale abdominal ultrasound was performed of these patients. All variables mentioned above for each patient was recorded and maintain in their individual case record form (CFR). Data was collected during allocated period. Statically package SPSS version 2.4 was used to check the collected data and to organize and compile results. According to results out of total 160 patients, 105 were females and 55 were male. Out of 160 patients 150 (93.8%) were present with gall stones and 10 (6.3%) were having no gall stone. In total 61 patients (38.1%) were having single gall stone whereas 89 (55.6%) were diagnosed with multiple gall stones. According to the results, minimum age was 18 years and maximum was 80 years. Our study concluded that obesity is one of the major risk factors for gall stones. Obesity is usually more common in females, so they are more likely to have gall stones and overweight patients were more prone to GB stones.

Body Mass Index and Waist to Height Ratio as an Indicator of Obesity in Gallstone Disease: Our 1 year experience

Background: Obesity is an established risk factor for gallstones. Body mass index (BMI) is a calculation index of general obesity. Waist circumference (WC) is a measure of body fat distribution and always used to estimate abdominal obesity. Using one single measure of obesity could not estimate persons at risk for Gallstone disease precisely. Aims: To Study if there any change in trend of relationship between body mass index/ waist-to height ratio in cholelithiasis patients. Objectives: To associate BMI and waist to height ratio with cholelithiasis. Materials and Methods: Type of study: Descriptive study. Sample size: 90 consenting patients diagnosed to have gallstone disease. Place of study: Department of General Surgery KIMS Hospital Bengaluru. Results: In the present descriptive study, 90 cases diagnosed with gallstone disease were selected by purposive sampling technique. They were between the ages of 21-80 years. Out of the ninety cases, thirty were males (33%) and sixty were females (67%). The female to male ratio was 2:1 Maximum number of cases were seen in the 31-40 and 41-50 year age groups that is forty four cases (48%). With peak incidence in 3rd decade. Body mass index was above normal in fifty nine patients (66%). Waist to height ratio was found to be above normal in sixty one patients (68%). suggestive of strong association with obesity. Conclusion: From the present descriptive study conducted at Department of General Surgery, KIMS Hospital Bengaluru is concluded that obesity has a strong association with gall stone disease, the main indicators of obesity being body mass index and waist to height ratio. The dictum of gall stone disease stating, the disease being more common in a “fertile fatty female of forties” is still valid.

Risk Factors for Gallstones and Cholecystectomy: A Large-Scale Population-Based Prospective Cohort Study in Japan

Introduction: Studies investigating the risk of gallstones in the Japanese population are sparse. To our knowledge, this is the first prospective cohort study assessing risk factors of gallstones in Japan. Methods: A nationwide population-based prospective cohort of 112,109 men and women, aged 40–69 years, self-completed questionnaires at baseline regarding exposures to potential risk factors, between 1990 and 1994. The occurrence of gallstones and cholecystectomy for gallstones were ascertained from another questionnaire after 10 years. Odds ratios and the 95% confidence intervals were calculated using the multivariate logistic regression. Results: During the 10-year follow-up, 3,092 (5.0%) participants developed gallstones and 729 (1.2%) participants required cholecystectomy. Increasing age, high body mass index, and diabetes mellitus were associated with the risk of gallstones in both sexes. In men, weight gain or loss of >5 kg over the follow-up period and stress were associated with risk of gallstones, whereas alcohol intake was inversely associated with the risk. In women, weight gain of >5 kg during the follow-up period, smoking, menopause, and lipid-lowering drugs were associated with risk of gallstones, whereas late onset of menarche was inversely associated with risk of gallstones. The risk of cholecystectomy broadly reflected the risk of gallstones for both sexes respectively. Conclusion: Risk factors for both gallstones and cholecystectomy for gallstones are multifactorial and differ between men and women. Novel findings in this study include an inverse association between late onset of menarche and gallstones, and an association between self-reported stress in men and gallstones.