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Segmental adenomyomatosis of the gallbladder predisposes to cholecystolithiasis
Author(s) -
Nishimura Atsushi,
Shirai Yoshio,
Hatakeyama Katsuyoshi
Publication year - 2004
Publication title -
journal of hepato‐biliary‐pancreatic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 0944-1166
DOI - 10.1007/s00534-004-0911-x
Subject(s) - adenomyomatosis , gallbladder , medicine , gastroenterology
Background/Purpose The aim of the present study was to clarify the association between adenomyomatosis of the gallbladder and cholecystolithiasis. Methods A cholecystectomy was performed for cholelithiasis or various other conditions in 1099 patients, of whom 608 had cholecystolithiasis. Adenomyomatosis of the gallbladder was classified as one of three variants: segmental, fundal, and diffuse. Segmental adenomyomatosis has an annular stricture dividing the gallbladder lumen into the “neck compartment” and the “fundal compartment”. Bile lipid analysis was performed in 8 patients with segmental adenomyomatosis. Results Adenomyomatosis of the gallbladder was observed in 156 patients (14.2%), of whom 99 had segmental adenomyomatosis, 54 had fundal adenomyomatosis, and 3 had diffuse adenomyomatosis. The prevalence of cholecystolithiasis was higher in patients with segmental adenomyomatosis (88.9%) than in those without adenomyomatosis (52.3%; P < 0.001). Gallstones were detected earlier in patients with segmental adenomyomatosis than in those without ( P < 0.001) and were located predominantly in the fundal compartment. Bile in the fundal compartment had lower concentrations of total bile acids ( P = 0.012), with an increased cholesterol saturation index ( P = 0.012), compared to bile in the neck compartment. Conclusions Segmental adenomyomatosis is a condition predisposing to cholecystolithiasis, probably due to the lithogenic environment in the fundal compartment. Fundal or diffuse adenomyomatosis appears to be unrelated to cholecystolithiasis.