Gallstone Disease Research Paper

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One of the most common causes of morbidity worldwide is the gallstone disease (6). Gallstone disease affects Western countries with a morbidity of 10-15% in adults (7). There are two major kinds of gallstones: cholesterol and pigment and the most common type are the cholesterol gallstones (5).
Cholesterol gallstones occur in the gallbladder and are made of 100% cholesterol (5). Cholesterol stones are yellow and have increasing proportions of calcium carbonate, phosphates, and bilirubin (5). They are oval and firm with most cholesterol stones being radiolucent even though there are 20% of cholesterol stones that are radio opaque due to significant calcium carbonate (5).
In the cholesterol secretion pathway, after the hepatocyte secretes cholesterol …show more content…
Gallbladder smooth muscle contracts due to the binding of CCK to its receptors on the plasma membrane followed by the activation of Gi-3 protein (3). However, in gallbladders with gallstones, there are significantly lower levels of CCK binding to its receptors (3). Motor function of the gallbladder smooth muscle becomes impaired causes reduced gallbladder contractility (3). Significant absorption of cholesterol from bile leads to excessive cholesterol being deposited within the sarcolemmal plasma membrane of the gallbladder smooth muscle which causes a decrease in membrane fluidity of the gallbladder muscle as well as impaired gallbladder contractility (10). Additionally, prolonged stasis of lithogenic bile in the gallbladder causes impaired gallbladder emptying that allows more time and environment for cholesterol crystallization and aggregation of that cholesterol into gallstones (3). Finally, decreased gallbladder motility associated with decreased food intake causes the formation of a biliary sludge made up of mucus, cholesterol crystals and calcium bilirubinate granules (1). Biliary sludge has high viscosity and an increased mucin and protein content which makes it a precursor to gallstones (1). Hence, gallbladder hypomotility along with biliary sludge facilitates the formation of cholesterol …show more content…
There are two major types of gallstones: cholesterol and pigment. Cholesterol gallstones are the most common type and its pathogenesis includes supersaturation of cholesterol in bile with subsequent development of cholesterol crystals; nucleation of cholesterol crystals due to pronucleator agent mucin that accelerates the maturation of cholesterol gallstones; and gallbladder muscle function impairment that causes gallbladder hypomotility. Although not a lot of research has been dedicated to pigment stones, it has been established that hard black stones are formed in the gallbladder due to hemolysis that causes hyperbilirubinbilia while soft laminated brown stones are formed due to the bacterial infection in the bile ducts that results in the pairing of unconjugated bilirubin with
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