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![Management of acute calculous cholecystitis according to Tokyo guidelines [126]. See text for details](publication/372403351/figure/fig1/AS:11431281175039237@1689552741946/Management-of-acute-calculous-cholecystitis-according-to-Tokyo-guidelines-126-See-text.png)
Management of acute calculous cholecystitis according to Tokyo guidelines [126]. See text for details
Source publication
About 20% of adults worldwide have gallstones which are solid conglomerates in the biliary tree made of cholesterol monohydrate crystals, mucin, calcium bilirubinate, and protein aggregates. About 20% of gallstone patients will definitively develop gallstone disease, a condition which consists of gallstone-related symptoms and/or complications requ...
Context in source publication
Context 1
... calcolous cholecystitis can become a life-threatening condition [134] and is managed according to the severity grade, i.e. mild (grade I), moderate (grade II), and severe (grade III), as described in the Tokyo Guidelines [123,125,126,129] (Fig. 5). All patients need monitoring with supportive care which include intravenous hydration, correction of electrolyte abnormalities, pain control, intravenous antibiotics, and fasting. In case of vomiting, the placement of a nasogastric tube is ...
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Choledocholithiasis occurring 40 years postcholecystectomy surgery is not commonly seen and is one of the longest reported latency period in literature today. Herein, we report a case of a 72 year old lady with previous open cholecystectomy 40 years ago, presented with acute onset right upper quadrant pain. Her bloods result revealed an obstructive...
Citations
... Mucins, especially secretory mucins, are present in the bile. Mucins also exist in cholesterol and pigment stones [17], and their roles in the pathogenesis of gallstones have been gradually recognised [18,19]. ...
Cholelithiasis is a common biliary tract disease. However, the exact mechanism underlying gallstone formation remains unclear. Mucin plays a vital role in the nuclear formation and growth of cholesterol and pigment stones. Excessive mucin secretion can result in cholestasis and decreased gallbladder activity, further facilitating stone formation and growth. Moreover, gallstones may result in inflammation and the secretion of inflammatory factors, which can further increase mucin expression and secretion to promote the growth of gallstones. This review systematically summarises and analyses the role of mucins in gallstone occurrence and development and its related mechanisms to explore new ideas for interventions in stone formation or recurrence.
... In fact, the prevalence of obesity has dramatically increased over the past 30-40 years in adults [3,4], children and adolescents [5]. Overweight and obesity, in turn, increase the risk of type 2 diabetes mellitus (T2DM), arterial hypertension, atherosclerosis, cardiovascular diseases [6,7], metabolic syndrome, dyslipidemia, cholesterol cholelithiasis [8], several malignancies [9], increased risk of severe COVID-19 [10], and metabolic dysfunction-associated steatotic liver disease (MASLD), among many other conditions and related complications. ...
The epidemiological burden of liver steatosis associated with metabolic diseases is continuously growing worldwide and in all age classes. This condition generates possible progression of liver damage (i.e., inflammation, fibrosis, cirrhosis, hepatocellular carcinoma) but also independently increases the risk of cardio-metabolic diseases and cancer. In recent years, the terminological evolution from “nonalcoholic fatty liver disease” (NAFLD) to “metabolic dysfunction-associated fatty liver disease” (MAFLD) and, finally, “metabolic dysfunction-associated steatotic liver disease” (MASLD) has been paralleled by increased knowledge of mechanisms linking local (i.e., hepatic) and systemic pathogenic pathways. As a consequence, the need for an appropriate classification of individual phenotypes has been oriented to the investigation of innovative therapeutic tools. Besides the well-known role for lifestyle change, a number of pharmacological approaches have been explored, ranging from antidiabetic drugs to agonists acting on the gut–liver axis and at a systemic level (mainly farnesoid X receptor (FXR) agonists, PPAR agonists, thyroid hormone receptor agonists), anti-fibrotic and anti-inflammatory agents. The intrinsically complex pathophysiological history of MASLD makes the selection of a single effective treatment a major challenge, so far. In this evolving scenario, the cooperation between different stakeholders (including subjects at risk, health professionals, and pharmaceutical industries) could significantly improve the management of disease and the implementation of primary and secondary prevention measures. The high healthcare burden associated with MASLD makes the search for new, effective, and safe drugs a major pressing need, together with an accurate characterization of individual phenotypes. Recent and promising advances indicate that we may soon enter the era of precise and personalized therapy for MASLD/MASH.
... С другой стороны, пациенты после резкого снижения массы тела или длительного голодания также имеют высокий риск образования камней вследствие застоя желчи. Кроме того, было продемонстрировано, что у женщин репродуктивного возраста или принимающих эстрогенсо-держащие контрацептивы образование камней в ЖП увеличивается в два раза по сравнению с мужчинами вследствие увеличения уровня холестерина в желчи и снижения сократимости ЖП [24][25][26][27]. Клинические симптомы при ЖКБ могут отсутствовать или проявляться скудно (тяжесть в правом подреберье). ...
Pathology of the biliary tract is widespread among the adult population of many countries around the world. This is due to the high incidence of risk factors in these populations. In addition to the commonality of risk factors and progression, another characteristic feature of the entire group of biliary diseases of both organic and functional nature is the presence of similar clinical manifestations. The main manifestation of biliary tract pathology is biliary pain. This article reflects modern data on the most common variants of biliary tract pathology in the practice of general practitioners and gastroenterologists in the light of the transition from ICD X to ICD XI, and presents a step-by-step diagnostic algorithm and approaches to the management of patients with biliary pain, including an example own clinical case.
... IR raises triglyceride levels while lowering high-density lipoprotein (HDL) cholesterol levels, both of which increase the chance of developing gallstones [12][13][14]. The prevalence of cholesterol gallstones is sharply increasing, in parallel with the global epidemics of insulin resistance, diabetes, elevated levels of visceral fat, obesity, and metabolic syndrome [15]. Obesity, particularly abdominal obesity, may contribute to the formation of gallstone [16]. ...
Background
The weight-adjusted-waist index (WWI) is a novel obesity index, and gallstones are associated with obesity. This study aimed to investigate the possible relationship between WWI and gallstones.
Methods
The datasets from the National Health and Nutrition Examination Survey (NHANES) 2017–2020 were used in a cross-sectional investigation. Multivariate linear regression models were used to examine the linear connection between WWI and gallstones incidence. Fitted smoothing curves and threshold effect analysis were used to describe the nonlinear relationship.
Results
The study comprised 8004 participants over the age of 20, including 833 reported with gallstones. Participants in the higher WWI tertile tended to have a higher gallstones prevalence. In the final adjusted model, a positive association between WWI and gallstones prevalence was observed (OR = 1.34, 95% CI: 1.20‒1.49). Participants in the highest WWI tertile had a significantly 71% higher risk of gallstones than those in the lowest WWI tertile (OR = 1.71, 95% CI: 1.35‒2.17). A nonlinear correlation was found between the WWI and gallstones prevalence, with an inflection point of 12.7.
Conclusions
Our study found that higher WWI levels connected with increased prevalence of gallstones. However, more prospective studies are needed to validate our findings.
... which is significantly greater than that in developing countries, and the incidence of gallstones continues to increase (5)(6)(7). This poses a significant healthcare burden in the United States. ...
... Gallstones are solid biliary conglomerates consisting of calcium bilirubinate, mucus, cholesterol monohydrate crystals, and protein aggregates and can be categorized into cholesterol gallstones and pigment gallstones, with the former accounting for more than 70% of all gallstones (5,11). Age, female, race/genetics, pregnancy, family history of gallstones, and sedentary lifestyle are a few well-known risk factors for gallstones (1,(12)(13)(14). ...
Introduction
Inflammation plays a significant role in gallstones formation. The prognosis of various illnesses was initially predicted using the systemic immune-inflammatory index (SII). We performed an updated analysis on the impact of SII and gallstones.
Methods
To investigate the connection between the SII and gallstones occurrence in a sample of individuals from the National Health and Nutrition Examination Survey (NHANES) database from 2017 to 2020, we employed logistic regression analysis, subgroup analysis, and smoothing curve fitting.
Results
In our study, an aggregate of 4,950 individuals over the age of 20 were enrolled, and 429 of them claimed to have gallstones. A fully adjusted model showed that the third and fourth quartiles of SII was parallel associated with gallstones in adults (OR = 2.43, 95% CI = 1.39–4.26; OR = 2.97, 95% CI = 1.72–5.16) under 50 years. Subgroup analysis and smoothed curve fitting provided evidence in favor of this finding.
Conclusion
According to our research, gallstones are more likely to occur in US adults younger than 50 years.
Background
Gallstone disease (GD) is common but remains asymptomatic in most cases. However, gallstones can lead to complications like choledocholithiasis or gallbladder cancer. In this study, we analyse the common genetic risk factor for GD, the p.D19H variant in the sterol transporter ABCG8 , in Polish patients with gallstones and gallbladder cancer.
Methods
Three adult cohorts were prospectively recruited: 65 patients with gallbladder cancer, 170 obese individuals scheduled for bariatric surgery and 72 patients who underwent endoscopic retrograde cholangiopancreatography due to recurrent choledocholithiasis. The control cohort consisted of 172 gallstone‐free adults. The ABCG8 p.D19H (rs11887534) polymorphism was genotyped using TaqMan assays.
Results
The minor allele frequency (MAF) of the ABCG8 p.D19H polymorphism was significantly ( p = .02) higher among cases with either gallstones or gallbladder cancer (MAF = 8.4%) as compared to controls (MAF = 4.0%). The highest frequency of the risk allele was detected in patients with gallbladder cancer (18.5%) and obese patients with GD (17.5%), followed by individuals with choledocholithiasis (13.9%). Notably, the p.19H variant was associated with an increased risk of developing gallbladder cancer (OR 2.76, 95% CI 1.16–6.54, p = .01) and an increased risk of GD in obese individuals scheduled for bariatric surgery (OR = 2.70, 95% CI 1.05–6.49, p = .03), but did not significantly affect the risk of choledocholithiasis.
Conclusions
The ABCG8 p.D19H common risk variant increases the risk of developing gallbladder cancer in Central Europeans and enhances the risk of gallstones in the obese. Carriers of the p.D19H variant might benefit from personalized preventive strategies, particularly regarding gallbladder cancer.
The fight against obesity is largely based on recommendations about lifestyle and therapies to initiate weight loss and, hopefully, to achieve and maintain an ideal weight. The failure of this approach is witnessed by the steady increasing rates of obesity worldwide. Lifestyle modifications yield mild weight loss with poor results in the long-term. The pharmaceutical industry is engaged to produce the best anti-obesity drugs, and this market is projected to grow massively. Guidelines on pharmacological and surgical approach to obesity are continuously developed, taking into account that benefits are counterbalanced by high costs, are limited to the period of drug intake, and potential adverse effects are possible, such as pancreatitis, gastroparesis, and bowel obstruction. Meantime, people living with obesity might simply think that taking the “magic pill” or undergoing bariatric surgery can change their life. In the long term, this tendency might lead to scarce cost-effectiveness, increasing adverse effects and inequities in the most vulnerable age classes. Furthermore, the main actors responsible for generating an obesogenic world will continue undisturbed to produce negative effects. Obesity is not only generated from voluntary individual behaviors, and no guideline can truly counteract the detrimental effects of environmental factors driving the progressive rise of obesity globally. Unsustainable food production, packaging and marketing, environmental pollution, widely diffused endocrine disrupting chemicals, and climate change are largely neglected by health professionals and generate food insecurity and malnutrition. The complexity of obesity cannot be managed only pointing to individual responsibilities of people living with obesity. There is a missing link here, and this war cannot be won in the absence of effective primary prevention measures involving changes in food production and marketing, and decreased release of toxic chemicals into the environment.
Gallstone disease (GD) is a common gastrointestinal disease. Although traditional diagnostic techniques, such as ultrasonography, CT, and MRI, detect gallstones, they have some limitations, including high cost and potential inaccuracies in certain populations. This study proposes a machine learning-based prediction model for gallstone disease using bioimpedance and laboratory data. A dataset of 319 samples, comprising161 gallstone patients and 158 healthy controls, was curated. The dataset comprised 38 attributes of the participants, including age, weight, height, blood test results, and bioimpedance data, and it contributed to the literature on gallstones as a new dataset. State-of-the-art machine learning techniques were performed on the dataset to detect gallstones. The experimental results showed that vitamin D, C-reactive protein (CRP) level, total body water, and lean mass are crucial features, and the gradient boosting technique achieved the highest accuracy (85.42%) in predicting gallstones. The proposed technique offers a viable alternative to conventional imaging techniques for early prediction of gallstone disease.
Introduction:
Gallstone disease (GD) is increasingly common among children, possibly caused by an unhealthy food environment and the associated unhealthy lifestyle. In this study, we investigate the association between body weight and gallstone risk in a cohort of prospectively recruited children with GD.
Methods:
We analysed 188 children with gallstones (50.0% girls, median age 9.8 years) and 376 children without stones who were age- and gender-matched to cases in a ratio of 2:1. Cases were prospectively recruited at three Polish university centres (Warsaw, Katowice and Bialystok). Gallstones were diagnosed by either abdominal sonography or by a history of cholecystectomy. Matched controls without gallstones were selected from 22,412 children taking part in nationally representative polish health surveys (OLA and OLAF studies) which provided height and weight data for randomly selected pre-school (2.5-6 years) and school aged (7-18 years) children and adolescents.
Results:
Analysis of the age- and gender-matched cases and controls demonstrated that patients with GD had significantly higher BMI (P = 0.02) and BMI z-score (P < 0.01) than children without stones. Children with gallstones were more frequently overweight (35.6%, P < 0.01) and obese (12.2%, P < 0.01) than controls (18.4% and 6.7%, respectively). Regression analyses showed that BMI, BMI z-score, overweight and obesity were all associated with increased GD risk (all P < 0.05).
Conclusions:
Overweight and obesity are common in children with cholelithiasis. Given the prevalence obesity in children we should expect an increasing prevalence of gallstones and stone-related complications in youths and in adults.
