Chronic Cholecystitis in Elderly Patients. Correlation of the Severity of Inflammation with the Number and Size of the Stones

Abstract

Backround: The present study focused on cholecystectomized elderly patients and aimed to investigate whether inflammation in the gallbladder wall was associated with the number and size of gallstones, as well as the patients' age. Patients and Methods: The present study included 306 cholecystectomized patients aged over 65 years. From the specimens derived from cholecystectomy, the gallstone number, the largest gallstone diameter and gallbladder wall thickness were determined. According to the histopathological examination, chronic inflammation was subdivided into mild-moderate and severe. Univariable analysis and multivariable logistic regression followed. Results: Mild-moderate inflammation characterized 63.4% of the cases and severe inflammation 36.6%. Solitary gallstones were found in 13.1% of the cases, while multiple gallstones were found in 86.9% of the cases. The largest gallstone diameter was less than 1 cm in the majority of cases (73.2%). The gallbladder wall thickness was associated with the degree of inflammation (p<0.001, Chi-square). In the univariable analysis, inflammation was positively associated with the diameter of the largest gallstone (p=0.032, Chi-square), but negatively associated with the number of gallstones (p<0.001, Chi-square) and patients< age (p=0.008, logistic regression). The number of gallstones was negatively associated with the diameter of gallstones and positively associated with the patients< age. The diameter of the largest gallstone was negatively associated with the patients< age. In the multivariable logistic regression, the effect of age (OR=0.95, 95% CI: 0.91-0.99) and solitary gallstones (OR=2.66, 95% CI: 1.02-6.93) on inflammation persisted, but that of the largest gallstone diameter vanished. Conclusion: The elderly population presented mainly with multiple and small gallstones. Solitary gallstones and younger age were the most important predictors for severe inflammation.