The relationship between gallstone disease and gallbladder wall thickness

Abstract

Background: The presence of Gallstones in the gallbladder is known to cause irritation of the gallbladder wall thereby resulting in the thickening of the gallbladder wall. On the other hand, an inflamed gallbladder, with its thickened wall, has been postulated to encourage super-saturation of gallbladder bile and subsequent gallstone formation.  This study was therefore designed to determine the relationship between the presence of Gallstones and Gallbladder wall thickness.

Methodology: 100 type 2 diabetic patients and 100 age and sex matched controls under-went real  time ultra-sonography  to determine the influence  of the presence of Gallstone on Gallbladder wall thickness. Their demographic characteristics and biochemical parameters were recorded and compared. Patients with confirmed diagnosis of type 2 diabetes mellitus (DM) (by WHO criteria) had right upper quadrant abdominal scan. The examinations were done in the morning following an overnight fast (to prevent Gall bladder contraction) without sedation. Longitudinal and transverse scans of the right upper quadrant was done in both the supine and left lateral positions. Ultrasound findings were considered positive for the presence of Gallstones only in those in whom reproducible echogenic masses with possible acoustic shadows were seen. The Gallbladder wall thickness was determined.

Result: The mean Gallbladder wall thickness in diabetic patients with Gallstone was 2.8 ± 1.4mm compared with 1.9 ± 0.9mm in those without Gallstones p=0.161.   The mean GB wall thickness in the control patients with GSD was 4.6 ± 3.7mm compared with 2.1 ± 1.2mm in those without GSD p=0.513.

Conclusions: The presence of Gallstones appears to increase the thickness of the Gallbladder wall (i.e in both diabetic patients and controls) .