Epidemiology and risk factors for gallstone disease: Has the paradigm changed in the 21st century?

Abstract

Gallstone disease is common and costly, creating over 700,000 cholecystectomies annually. Its complications consume approximately $6.5 billion in the United States. Surveys using noninvasive ultrasonography have identified its true prevalence and the associated risk factors. In developed countries, at least 10% of white adults harbor cholesterol gallstones; women have twice the risk, and age further increases the prevalence in both sexes. Gallstones reach epidemic proportions in the North and South American Indian populations, accompanied by an increased risk for gallbladder cancer. In contrast, the rate in sub-Saharan Africa and Asia is quite low. Obesity, a major risk factor, likely relates to insulin resistance (the metabolic syndrome). Evolution and circumstance in American Indians may have ironically selected those with "thrifty" genes that conserve energy. Our abundant access to food places us at the increased risk of obesity and cholelithiasis. The general rise in obesity in many countries raises the specter of heightened disease, best identified by epidemiologic studies.

Comparison of Cosmetic Outcome Between Single-Incision Laparoscopic Cholecystectomy and Conventional Laparoscopic Cholecystectomy in Rural Indian Population: A Randomized Clinical Trial

“…The progress in laparoscopic surgery offers the patients advantages of preservation of integrity of the abdominal wall, less operative trauma, early recovery, and improved cosmesis [18,19]. The recent progress in SILC is driven mainly by cosmetic advantages, without the risks and technical limitations associated with NOTES.…”

Diagnosis ofacute cholecystitis using ultrasonography

“…But the difference decreased in the over 60 age grou,represent5.0%.It was observed thatacute calculuscholecystitiswere common in obese patients (46%).There is, however, an important proportion of patients presenting with tenderness when putting the probe on the right upper quadrant area(38%).Jaundicerepresents 21% of patients whocame with high leucocytosisand 79% were not with high leucocytosis. There is strong relation between body mass index and gallbladder stone, gallstone 19% percentage as increase when compare with thin and medium patient, this due to increase consumption of fatty ducts which elevate the cholesterollevels..Strong relation between the body mass index and gallstones, there is 53% of the patient who came for abdomen ultrasound and the other 47% percentage is for thin and medium patients.It was documented that the sonographic features most frequently encountered in patients with acute cholecystitiswas parietal thickening, also described in literature as correlating with the inflammatory process (28,29) . Thestatistical analysis of the mean gallbladder wall thickness(2.3 to 8.0mm),The results of our study confirm the literature data showing statistically significant correlations between the parietal dimensions described ultrasonographically and those measured during surgery byBingener et al [28] .…”

“…There is strong relation between body mass index and gallbladder stone, gallstone 19% percentage as increase when compare with thin and medium patient, this due to increase consumption of fatty ducts which elevate the cholesterollevels..Strong relation between the body mass index and gallstones, there is 53% of the patient who came for abdomen ultrasound and the other 47% percentage is for thin and medium patients.It was documented that the sonographic features most frequently encountered in patients with acute cholecystitiswas parietal thickening, also described in literature as correlating with the inflammatory process (28,29) . Thestatistical analysis of the mean gallbladder wall thickness(2.3 to 8.0mm),The results of our study confirm the literature data showing statistically significant correlations between the parietal dimensions described ultrasonographically and those measured during surgery byBingener et al [28] . Chen and Colab.reported an increasein the conversion risk at a sonographically-measured parietal thickness of more than 6 mm [30,31] .…”

Routine Histopathologic Examination of Two Common Surgical Specimens—Appendix and Gallbladder: Is It a Waste of Expertise and Hospital Resources?

“…However, it is not unusual to observe it in some parts of India, Chile, Bolivia, and Mexico [10][11][12], and is the most common biliary cancer worldwide.…”