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Gallbladder disease in cystic fibrosis
M C Jebbink1, H G Heijerman, A A Masclee
1Department of Gastroenterology and Hepatology, University Hospital Leiden, Netherlands.
The Netherlands Journal of Medicine
|October 1, 1992
Summary
Cystic fibrosis (CF) patients frequently develop gallbladder issues like gallstones and nonfunctioning gallbladders. Understanding the causes and improving surgical options are crucial for managing these gastrointestinal complications.
Area of Science:
- Gastroenterology
- Hepatology
- Pediatric Medicine
Background:
- Gallbladder abnormalities are common in cystic fibrosis (CF) patients.
- Prevalence includes nonfunctioning gallbladders (30%), micro-gallbladders (8-30%), and gallstones (4-30%).
- Pathophysiology remains unclear due to conflicting data on bile acid metabolism, nucleation time, and biliary stasis.
Purpose of the Study:
- To review the pathophysiology and diagnosis of gallbladder disease in CF.
- To discuss current treatment options and associated risks.
- To explore potential alternative surgical approaches.
Main Methods:
- Literature review of gallbladder abnormalities in CF patients.
- Analysis of pathophysiology, diagnostic challenges, and treatment outcomes.
- Discussion of surgical interventions and their implications.
Main Results:
- High prevalence of gallbladder dysfunction and gallstones in CF.
- Diagnostic delays are common due to overlapping GI symptoms.
- Cholecystectomy carries significant risks (10% morbidity, 5% mortality) in CF patients.
Conclusions:
- Gallbladder disease is a significant gastrointestinal complication in CF.
- Careful pre- and perioperative management is essential for cholecystectomy.
- Laparoscopic cholecystectomy warrants further investigation as a potentially safer alternative.