Effects of Chemical Composition of Cholesterol and Pigment Stones on the Gallbladder Mucosa

Authors

  • Sanum Ali
  • Shahid Rasul
  • Surrendar Dawani
  • Sarah Zahid
  • Sehrish Hussain
  • Ovais Sarwar
  • Tanweer Fatima
  • Zainab Tariq

DOI:

https://doi.org/10.51985/JBUMDC202195

Keywords:

Cholelithiasis, Gallstones, Gallstone disease, Hyperplasia

Abstract

Objective: To compare the effect of chemical composition of cholesterol and pigment stones on gallbladder mucosa.
Study design & setting: This comparative cross-sectional study was conducted in the Department of Anatomy, BMSI,
JPMC, Karachi, Pakistan, from April to September 2021.
Methodology: Total n= 120 gallbladder specimens were collected after cholecystectomies in 10% formalin. Gross
morphological features of gallbladder and stones were observed. Specimens were processed and 5µm sections from fundus,
body & neck of gallbladder were stained and examined for microscopic changes. Chemical analysis of stones was carried
out to differentiate between cholesterol & pigment stones.
Results: We evaluated different histomorphological alterations in gallbladder with reference to both type of gallstones.
Muscular wall thickness in pigment stone group was noted to be (143.89±78.66) and in cholesterol group (158.37±83.95).
Both pigment and cholesterol stone showed increased tendency of muscular hypertrophy. Mucosal ulceration, chronic
inflammatory cell infiltration, capillary congestion and hyperplasia (p-value: 0.04) were observed in both type of stones.
Statistical analysis showed that large cholesterol stones produce significant histopathological changes (p-value: 0.004);
greater the size of stone, more profound was the mucosal hyperplasia. Rokitansky-Ashcoff sinuses were predominant in
gallbladders with cholesterol stone.
Conclusion: Gallstones cause series of histopathological changes ranging from chronic cholecystitis to pre-malignant and
malignant changes. Hyperplasia was observed to be more frequent with long standing, large cholesterol stones

References

Standring S, editor. Gray's anatomy: the anatomical basis of

clinical practice: Gallbladder and biliary tree. 41st Ed.

ELSEVIER; 2016.p. 1173.

Grigor’eva IN, Romanova TI. Gallstone Disease and

Microbiome. Microorganisms 2020; 8(6): 835. doi.org/10.3390

/microorganisms8060835

Krawczyk M, Miquel JF, Stokes CS, Zuniga S, Hampe J,

Mittal B, et al. Genetics of biliary lithiasis from an ethnic

perspective. Clin Res Hepatol Gastroenterol 2013; 37(2) :119-

doi.org/10.1016/j.clinre.2012.09.002

Abeer FK, Babar K, Jaffar R, Fatima G, Salahuddin H. Analysis

of Various Histopathological Lesions in Routine Cholecystectomy Specimens. Med Forum 2020; 31(12): 94-97.

Aslam S, Hameed S, Husain A, Mudassar M, Khan HA.

Histopathologic Spectrum of Gallbladder in Cholecystectomy

Specimens. A.P.M.C. 2020; 14(1): 92-96. doi.org/ 10.29054/

apmc/2020.851

Goral V. Gallstone etiopathogenesis, lith and mucin genes

and new treatment approaches. Asian Pac J Cancer Prev 2016;

(2): 467-471. doi: 10.7314/apjcp.2016.17.2.467.

Gaharwar A, Mishra SR, Kumar V. A study on Cholecystectomy Specimens. J. Anat. Sciences 2016; 24(1): 7-12.

Bangash M, Alvi AR, Shahzad N, Shariff AH, Gill RC. Factors

Associated with Premalignant Epithelial Changes in Chronic

Calculous Cholecystitis: A Case–Control Study. World J Surg

;42(6):1701-1705. doi.org/10.1007/s00268-017-4371-2

Hundal R, Shaffer EA. Gallbladder cancer: epidemiology and

outcome. Clin Epidemiol. 2014; 6: 99-109. doi: 10.2147/

CLEP.S37357

Gopalakrishnan M, Thilagavathy S, Kamaleshwari J, Shifa

R. Morphological spectrum of changes in gall bladder in

correlation to various types of gallstones: a study of 100 cases.

Ann Appl Biosci 2016; 3(2): 196-202.

Pillai V, Sreekantan R, Chisthi MM. Gall bladder stones and

the associated histopathology–a tertiary care centre study. Int

J Res Med Sci 2017; 5(4): 1368-1372. doi:10.18203/2320-

ijrms20171228

Gupta P. Assessment of Gall Bladder Mucosal Changes in

Gall Stone Patients. JAMDSR 2019; 7(8): 112-114. doi:

21276/jamdsr

Aslam HM, Saleem S, Edhi MM, Shaikh HA, Hafiz M,

Saleem M. Assessment of gallstone predictor: comparative

analysis of ultrasonographic and biochemical parameters. Int

Arch Med 2013; 6(1): 1-7. doi.org/10.1186/1755-7682-6-17

Osuch C, Dolecki M, Rogula W, £apiak A, Matyja M,

Czerwiñska A, et al. Gender as a predictive factor in

cholecystectomy-is it true or false? Folia Med Cracov 2020;

(2): 97-107. doi: 10.24425/fmc.2020.135016

Bilal M, Haseeb A, Saad M, Ahsan M, Raza M, Ahmed A,

et al. The prevalence and risk factors of gallstone among

adults in Karachi, south Pakistan: A population-based study.

J Glob Health Sci 2016; 9(4): 106-114. doi:10.5539/ gjhs.

v9n4p106

Shabbir A, Irshad Z, Javed S, Nadeem F, Jaffar N, Hasan SM.

Morphological Spectrum of Gall Bladder Diseases at a Tertiary

Care Hospital of Karachi. Annals of Jinnah Sindh Medical

University 2020;6(1):24-28. doi.org/10.46663/ajsmu.v6i1.24-

Gupta K, Faiz A, Thakral RK, Mohan A, Sharma VK. The

spectrum of histopathological lesions in gallbladder in

cholecystectomy specimens. Int J Clin Diagnostic Pathol

; 2(1): 146-151. doi.org/10.33545/pathol.2019.v2.i1c.22

Zaki M, Al-Refeidi A. Histological changes in the Human

Gallbladder Epithelium associated with gallstones. Oman

Med J 2009; 24(4): 269-273. doi:10.5001/omj.2009.55

Zuhair M. Histological Changes of Gall Bladder Mucosa:

Correlation with Various Types of Cholelithiasis. Iraqi J.

Comm Med 2011; 24(3): 234-240

Vitetta L, Sali A, Little P, Mrazek L. Gallstones and gall

bladder carcinoma. ANZ J Surg 2000; 70(9): 667-73.

doi.org/10.1046/j.1440-1622.2000.01926.x

Singh A, Singh G, Kaur K, Goyal G, Saini G, Sharma D.

Histopathological changes in gallbladder mucosa associated

with cholelithiasis: A prospective study. Niger J Surg: official

publication of the Nigerian Surgical Research Society 2019;

(1): 21-25. doi: 10.4103/njs.NJS_15_18

Downloads

Published

2022-04-01

How to Cite

Ali, S. ., Rasul, S. ., Dawani, S. ., Zahid, S. ., Hussain, S. ., Sarwar, O. ., Fatima, T. ., & Tariq, Z. . (2022). Effects of Chemical Composition of Cholesterol and Pigment Stones on the Gallbladder Mucosa. Journal of Bahria University Medical and Dental College, 12(02), 68–72. https://doi.org/10.51985/JBUMDC202195

Issue

Section

Original Articles