Histologic findings of gallbladder mucosa in 87 patients with morbid obesity without gallstones compared to 87 control subjects

Obesity is an important risk factor for the development of gallstones. The purpose of this study was to determine histologic alterations in the gallbladder mucosa and the prevalence of gallstone disease in patients with severe and morbid obesity compared to histologic findings in the gallbladder mucosa of control subjects. Two groups were studied: 125 severely obese patients (38 with and 87 without gallstones) and 87 control subjects. Ultrasonography was performed in all of them before surgery. During surgery, cholecystectomy was performed in 87 obese patients with a "normal" gallbladder and in all 87 control subjects. Specimens were immediately sent for histologic analysis. The prevalence of gallstones was twice as high among obese women compared to obese men (P < 0.001). Normal gallbladder mucosa was found in 28.7% of obese women compared to 34.2% of control women (P > 0.59). Findings were similar among the men. The most frequent histologic abnormality in the gallbladder mucosa among obese women was cholesterolosis (37%), followed by chronic cholecystitis and cholesterolosis (18%), with frequencies of 23% and 12%, respectively, in control women (P > 0.1). Among men, a similar proportion of histologic abnormalities was seen in obese men and control subjects. In our population of obese patients compared to control subjects, a similarly high proportion of histologic abnormalities of the gallbladder mucosa was found in the absence of stones. These findings could have been attributed to the fact that the Chilean population has a high incidence of gallstones. (C) 2003 The Society for Surgery of the Alimentary Tract, Inc.