Calculous cholecystitis - multifactorial, t. a disease developing as a result of exposure to many causative factors, acute or chronic inflammation of the gallbladder, a prerequisite for which is the presence of stones (calculi) in its lumen.

Calculous cholecystitis - inflammation of the gallbladder with the formation of stones in its lumen.

Despite the fact that chronic calculous cholecystitis is the main manifestation of gallstone disease, its symptom form, in most cases, these concepts are usually identified, i.e.. the presence of stones in the cavity of the gallbladder irreversibly leads to the development of inflammatory changes in it, asymptomatic calculus is a rather rare phenomenon.

Currently, in economically developed countries, there is a steady tendency to an increase in the incidence of about 2 times every 10 years.. Recent studies indicate that 1/10 of the world's population suffers from calculous cholecystitis, according to preliminary estimates by 2050 the number of such patients will at least double.. In the Russian Federation, the prevalence of the disease is approximately 12%, in most cases people aged 40 to 60 suffer, women get sick 6 times more often than men.

Calculous cholecystitis is sometimes called a " the main prerequisites for its development are an excessive amount of animal fats, refined carbohydrates in the diet, a small amount of plant foods, a high calorie content of the meals consumed.

In the structure of the surgical pathology of the gastrointestinal tract, calculous cholecystitis also occupies one of the leading positions: for example, in Russia, more than 100,000 operations on the abdominal cavity are performed annually for the removal of an altered, functionally incompetent gallbladder.

Causes of calculous cholecystitis and risk factors for its development The gallbladder is a hollow saccular organ with a thin wall, with a volume of 30 to 70 ml, lying in the corresponding fossa on the hepatic surface. The production of bile does not occur in it: here it accumulates, being delivered from the liver lobules along the common hepatic and cystic ducts, and matures.

After each meal (in portions), as well as in small volumes during the day, bile is released from the bladder into the duodenum through the bile duct to ensure normal physiology of digestion. In total, 500-600 ml of bile is formed in the liver per day.

As a result of changes in the physicochemical properties of bile, its infection, impaired motility (dyskinesia) of the ducts, the presence of some concomitant diseases and the effects of other causes, sediment precipitation occurs, the formation of microcrystallization embryos transforming into gallstones (calculi).

Stagnation of bile is accompanied by damage to the inner lining of the gallbladder, the release of pro-inflammatory enzymes and inflammatory mediators, which provoke the development of a local inflammatory reaction, to which, often, a bacterial infection joins again (normally bile is sterile).

Concrements in most cases have a rounded shape, sometimes - faceted, ground to each other surfaces (faceted stones), can be single and multiple, in severe cases, occupying the entire lumen of the bladder.

In terms of chemical composition, gallstones can be of the following types:.

cholesterol (formed around crystallized cholesterol molecules);

pigmented (consisting mainly of calcium bilirubinate, formed from precipitation of insoluble indirect bilirubin);

mixed.

Causes of calculous cholecystitis:.

chronic hemolytic anemia;

cirrhosis of the liver (including with alcoholic illness);

infectious processes in the bile ducts;

congenital metabolic diseases;

dysfunction of the intestinal-hepatic circulation (long-term parenteral nutrition, pathology or resection of the ileum);

enzymatic pathologies;

pathology of the structure of the hepatobiliary zone, which determines the violation of the passage of bile;

systematic violation of the principles of balanced nutrition;

stagnation in the gallbladder, provoked by mechanical compression by volumetric neoplasms of neighboring organs.

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