Cholelithiasis in the Aged

an Autopsy Study

Abstract

Many reports on the cholelithiasis have been published. The gallstones are frequently found at autopsy materials and the increasing incidence of gallstones with advancing age is well known. Cholelithiasis is one of the most important diseases in the aged. In this paper, cholelithiasis was studied upon an analysis of 1070 autopsy cases of elderly patients over the age of 60 at Yokufukai Geriatric Hospital, Tokyo, during a period of 11.5 years from the beginning of 1962 to July 1973. Results are shown below.
1) The gallstones were present in 201 cases (18.8%) of 1070 autopsied patients. The incidence of gallstones was high in the elderly group and greater in the female (21.4%) than in the male (13.9%) with a ratio of 1.5 to 1.
2) Of 201 autopsied patients with cholelithiasis, 191 (95.0%) had gallstones in the gallbladder, 24 (11.9%) in the common bile duct, 6 (3.0%) in the intra-hepatic duct, 6 (3.0%) in the cystic duct, and 2 (1.0%) in the hepatic duct.
3) There was a ratio of 4.3 to 1 of cholesterol stone to bilirubin stone in the male and a ratio of 9.2 to 1 in the female.
4) Fifty-two per cent of cholelithiasis in the gallbladder had been asymptomatic in the male and 58per cent in the female. On the other hand, 50per cent of cholelithiasis in the biliary ducts had been asymptomatic in the male and 41.7per cent in the female.
5) Most of clinical diagnosis in 201 cases with gallstones were central nervous, cardiovascular or respiratory diseases. The diagnosis of cholelithiasis had been made correctly in 9.6per cent in the male and in 8.7per cent in the female.
6) The mortality of cholelithiasis proved to be 7.7per cent in the male and 4.7per cent in the female.
7) The percentage of developing cancer of the gallbladder in the presence of cholelithiasis was 2.1per cent in the female. On the other hand, the incidence of gallstones in the presence of carcinoma of gallbladder was 60per cent.