Gallstones in <scp>N</scp>ew <scp>Z</scp>ealand: composition, risk factors and ethnic differences

Stringer, Mark D.; Fraser, Sara J.; Gordon, Keith C.; Sharples, Katrina; Windsor, John A.

doi:10.1111/j.1445-2197.2012.06234.x

Cited by 17 publications

(17 citation statements)

References 28 publications

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“…These rates are further summarized in Figure 2. Gallbladder cancer as a consequence of long-standing gallstones is also over-represented among New Zealand Maori,17 suggesting an increased prevalence of gallstones in this native population 18. Ethnic predilections exist in the USA, where Caucasians carry a higher prevalence of gallstones (16.6% of women and 8.6% of men) compared with Black Americans (13.9% of women and 5.3% of men) 14,19…”

Section: Risk Factorsmentioning

confidence: 99%

Gallbladder cancer: epidemiology and outcome

Hundal¹,

Shaffer²

2014

CLEP

575

435

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Gallbladder cancer, though generally considered rare, is the most common malignancy of the biliary tract, accounting for 80%–95% of biliary tract cancers. An early diagnosis is essential as this malignancy progresses silently with a late diagnosis, often proving fatal. Its carcinogenesis follows a progression through a metaplasia–dysplasia–carcinoma sequence. This comprehensive review focuses on and explores the risks, management, and outcomes for primary gallbladder carcinoma. Epidemiological studies have identified striking geographic and ethnic disparities – inordinately high occurrence in American Indians, elevated in Southeast Asia, yet quite low elsewhere in the Americas and the world. Age, female sex, congenital biliary tract anomalies, and a genetic predisposition represent important risk factors that are immutable. Environmental triggers play a critical role in eliciting cancer developing in the gallbladder, best exemplified by cholelithiasis and chronic inflammation from biliary tract and parasitic infections. Mortality rates closely follow incidence; those countries with the highest prevalence of gallstones experience the greatest mortality from gallbladder cancer. Vague symptoms often delay the diagnosis of gallbladder cancer, contributing to its overall progression and poor outcome. Surgery represents the only potential for cure. Some individuals are fortunate to be incidentally found to have gallbladder cancer at the time of cholecystectomy being performed for cholelithiasis. Such an early diagnosis is imperative as a late presentation connotes advanced staging, nodal involvement, and possible recurrence following attempted resection. Overall mean survival is a mere 6 months, while 5-year survival rate is only 5%. The dismal prognosis, in part, relates to the gallbladder lacking a serosal layer adjacent to the liver, enabling hepatic invasion and metastatic progression. Improved imaging modalities are helping to diagnose patients at an earlier stage. The last decade has witnessed improved outcomes as aggressive surgical management and preoperative adjuvant therapy has helped prolong survival in patients with gallbladder cancer. In the future, the development of potential diagnostic markers for disease will yield screening opportunities for those at risk either with ethnic susceptibility or known anatomic anomalies of the biliary tract. Meanwhile, clarification of the value of prophylactic cholecystectomy should provide an opportunity for secondary prevention. Primary prevention will arrive once the predictive biomarkers and environmental risk factors are more clearly identified.

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Section: Risk Factorsmentioning

confidence: 99%

Gallbladder cancer: epidemiology and outcome

Hundal¹,

Shaffer²

2014

CLEP

575

435

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“…Cholecystectomy is among the top 10 surgical procedures performed each year in Western societies; 2 with more than 500 000 patients are performed annually in the United States, consuming resources estimated at $6.5 billion (Stringer et al, 2013). In the present study, we demonstrated that gallbladders excised from patients with symptomatic cholelithiasis, even without any evidence of inflammation, might host bacteria in over 20% of cases (Gosling et al,1996).…”

Section: Author(s) Agree That This Article Remains Permanently Open Amentioning

confidence: 48%

“…Gallstone disease is a common and costly disorder worldwide; it is often asymptomatic, biliary colic, cholecystitis and entails life-threatening complications such as obstructive jaundice (Stringer et al, 2013). The pathophysiological role of bacteria in the formation of gallstones was proposed long ago.…”

Section: Introductionmentioning

confidence: 99%

Correlation between biliary bacteriology and types of gallstones in uncomplicated symptomatic cholelithiasis

Ismet¹,

Ozaydin²,

Acar³

et al. 2016

Afr. J. Microbiol. Res.

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The aim of this study was to identify the microflora in the gallbladder of patients undergoing cholecystectomy for different types of gallstones and the antibiotic susceptibility pattern of the isolates. were from cholesterol stone-containing bile and 132 isolates (62.8%) from pigment stone-containing bile (P<0.01). The overall bacterial isolates from bile samples revealed Escherichia coli (E. coli) predominantly, followed by Pseudomonas aeruginosa (P. aeruginosa) and Enterococcus spp. In one sample, we found Candida lusitaniae (C. lusitaniae). None of the Gram negative strains were resistant to antibiotics but Gram positive strains were highly resistant to penicillins (100%). Looking at the microflora of the gallbladder and the susceptibility pattern of our isolates, we would suggest that antibiotic prophylaxis recommended for laparoscopic or open cholecystectomy for gallstones be reviewed and the role of bacteribilia in the surgical management of cholelithiasis requires further study.

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“…The prevalence of the most frequent type of gallstone remained a controversy in the literature. With a prevalence ranging from 36.8 to 53.0% some authors [4–6] reported pure cholesterol gallstone as the predominant type; authors [7–12] reporting a prevalence of pigment gallstone of 37.2% −35% sustained the predominance of this type; elsewhere in the literature, mixed gallstone (66.7% - 89.14%) was reported to be predominate [13–15].…”

Section: Introductionmentioning

confidence: 99%

Risk Factors Associated to Types of Gallstone Diagnosed at Ibn-Sina Specialized Teaching Hospital, Khartoum, Sudan

Mi¹,

Aa²,

Jervase³

et al. 2019

Preprint

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3 4 Introduction 3 5Gallstone disease (Cholelithiasis) affects 10 to 15% of the population of developed countries. Our 3 6 study aimed to determine the risk factors associated to different types of gallstone in patients 3 7 diagnosed in Khartoum State Ibnsina Gastroenterology Center. 3 8 Methods 3 9 A facility-based prospective cross-sectional study was implemented on a convenient sample of 47 4 0 participants diagnosed with gallstone through ultrasonography in Ibnsina Gastroenterology center 4 1 and who underwent surgical interventions for gallstone removal. A standardized interviewer-4 2 administrated research tool comprising three parts was used to collect data related to the 4 3 characteristics of the participants, their medical presentation and examination as well as 4 4 information on types of gallstone, surgical interventions and outcomes. The data were 4 5 computerized through Epi-info 7 and analyzed through SPSS 23. Descriptive statistics were firstly 4 6 performed and association was tested through Chi square tests and ANOVA. A multinomial 4 7 regression analysis established the relationship between types of gallstone and their associated risk 4 8 factors. All statistical tests were considered as significant when p < 0.05. 4 9 Results 5 0The risk factors statistically associated to gallstone types were family history (p = 0.011) and 5 1 duration of living in the residence area (p= 0.043) in pigment-cholesterol gallstone model vs 5 2 mixed-cholesterol gallstone model. Other four risk factors contributing to the pathogenesis of 5 3 gallstone were parity (OR = 1.623 [95% CI: 0.795-3.315]) vs (OR = 1.426, [95% CI: 0.729-5 4 2.790]), waist circumference (OR= 1.014 [95% CI: 0.948-1.085]) vs (OR = 1.001 [95% CI: 0.942-5 5 1.065]), chronic disease (OR = 0.698, [95% CI: 0.028 -17.445]) vs (OR = 0.354, [95% CI: 0.021-5 6 6.087]) and serum triglyceride (OR = 0.985, [95% CI: 0.950-1.022]) vs (OR= 0.980, [95% CI: 5 7 0.949-1.012]). 5 8 Conclusion 5 9 Our finding indicated six risk factors related to types of gallstone. Further multicenter research in 6 0Sudan on risk factors is needed to calibrate and validate our model. 6 1 Keyword: Cholelithiasis, Gallstone disease, Risk factors, Types of gallstone, Ultrasonography.6 2 6 3 9 1gallstone as well as between types of gallstone and positive history of type 2 diabetes (p=0.035). 2The other risk factors assessed were family history of GSD, history of dyslipedemia, total 9 3 cholesterol, triglycerides, high density lipoprotein cholesterol, low density lipoprotein cholesterol, 9 4 fasting blood glucose, parity and use of exogenous oestrogen in female patients, smoking and 9 5 alcohol consumption in males were not statistically associated (p >0.05) to the types of gallstone. 6Another study [29] on a sample of 100 patients investigated the association between gallstone 9 7 characteristics and 23 patient parameters. A statistically significant association was found between 9 8 both mean diastolic (p=0.012) and systolic blood pressure and types of gallstone (p=0.027).

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Gallstones in New Zealand: composition, risk factors and ethnic differences

Abstract: This novel prospective study highlights risk factors and ethnic differences in gallstone composition in New Zealand. These may be important when considering gallstone prevention strategies.

Cited by 17 publications

References 28 publications

Gallbladder cancer: epidemiology and outcome

Gallbladder cancer: epidemiology and outcome

Correlation between biliary bacteriology and types of gallstones in uncomplicated symptomatic cholelithiasis

Risk Factors Associated to Types of Gallstone Diagnosed at Ibn-Sina Specialized Teaching Hospital, Khartoum, Sudan

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