Pathohistological Investigation of Operative Cases with Silent Gallstones

Abstract

The problem of whether or not cholecystectomy should be performed for silent gallstones is discussed. There have been many clinical investigations of symptomatic and asymptomatic gallstones. However, there have been few pathohistological investigations of gallbladder with silent stones. We experienced 39 cases (210.4%) with silent gallstones in 375 patients operated on for gallstones. The 375 cases were divided into three groups, severe, moderate, and mild, according to the grade of inflammatory cellular infiltration in the mucosal layer of the gallbladder. These three histological groups were 51.7%, 33.0%, and 15/3% of the symptomatic gallstone cases, respectively, and 48.7%, 23.1%, and 28.2% of the asymptomatic gallstone cases. There was no significant pathohistological difference between symptomatic and asymptomatic gallstones. Even if the case is silent gallstone, there are histological findings of severe cholecystitis in gallbladder, symptomatic possibility or the potentiality of canceration, and the restriction of life due to carrier of gallstone. Moreover, laparoscopic cholecystectomy that is less of surgical stress, popularizes these days. Therefore, we consider cholecystectomy appropriate for silent gallstones.