International Surgery Journal | January 2018 | Vol 5 | Issue 1 Page 286
International Surgery Journal
Patel G et al. Int Surg J. 2018 Jan;5(1):286-291
http://www.ijsurgery.com pISSN 2349-3305 | eISSN 2349-2902
Original Research Article
Liver biopsy in gall stone disease: a prospective study in patients
undergoing cholecystectomy
Gaurav Patel
1
, Atul Jain
1
*, Malwinder Singh
1
, Meenu Garg
2
, Tanweer Karim
1
, Subhajeet Dey
1
INTRODUCTION
Cholelithiasis has affected mankind since many centuries.
Archaeological excavation demonstrating the presence of
gallstone in mummies of young Egyptian women proves
the age-old existence of this disease.
1
This disorder, which constitutes a major burden on the
community (prevalence 6%) is more common in females
as compared to males (3:1) and in approximate 15%
cases first degree relatives are affected.
2,3
The first successful cholecystectomy was performed in
1882 by Langenbuch in Germany. In the present time
cholecystectomy remains the standard treatment of
cholelithiasis despite the advent of gallstone dissolving
drugs and extracorporeal lithotripsy.
4
In patients of gallstone disease, cholangitis can develop
which on long run can cause secondary changes in liver
like fatty liver, fibrosis, secondary biliary cirrhosis,
reactive hepatitis, nonspecific inflammatory changes etc.
ABSTRACT
Background: Cholelithiasis has affected mankind since many centuries. It not only affects the biliary tree but also
has adverse effects on the hepatic parenchyma, which can get further complicated due to infected bile. Early
intervention in these cases not only retards the unwanted effects but also prevents irreversible damage to liver. Aim of
study was to see the effect of gallstone disease on liver in patients of GSD (Cholelithiasis, Chronic cholecystitis, CBD
Stones).
Methods: All patients being subjected for planned cholecystectomy were taken as subjects irrespective of age, sex
and co-morbid conditions.
Results: 90 patients were included in study and they were evaluated for secondary histopathological changes in liver.
Abnormal liver histology was seen in 40% of the cases, with portal tract inflammation being the commonest
abnormality seen in 24.4% of patients followed by fatty change (17.8%), cholestasis (10%), lobular parenchymal
infiltration (8.9%) and one (1.1%) patient had fibrosis. Choledocholithiasis was associated with a greater incidence of
positive bile culture (60%) and greater incidence of abnormal liver histology (80%).
Conclusions: Gall stone disease cause significant changes in liver histology and these changes are more common in
those patients having long duration of symptoms. In patients of choledocholithiasis incidence of infected bile and
liver histology changes are more as compared to cholelithiasis with chronic cholecystitis.
Keywords: Cholelithiasis, Choledocholithiasis, Gall stone disease, Liver histology, Liver biopsy
1
Department of Surgery, ESI PGIMSR and Hospital, Basaidarapur, New Delhi, India
2
Department of Microbiology, LNJP Hospital, New Delhi, India
Received: 13 November 2017
Accepted: 11 December 2017
*Correspondence:
Dr. Atul Jain,
E-mail: docatuljain@gmail.com
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
DOI: http://dx.doi.org/10.18203/2349-2902.isj20175912