[Etiology and therapy of cholecystitis and cholelithiasis]

Microscopic examinations of 1,000 ectomized gallbladders in patients with acute acalculous as well as calculous cholecystitides render possible a morphologic definition of the changes which are responsible for the beginning of a disease of the biliary duct. The cases in question are oedema, haemorrhages and necroses in the wall of the gall-bladder. These changes are evoked by pathologic angioneurotic reactions which take place in the supply area of the cystic artery during the gall colic. As their sequelae gallstones develop as was shown by the microscopic examinations of the fluid content of the operated gall-bladders and the gallstones. Changes in the wall of the gall-bladder in chronic cholecystitis are reparable processes of lesions which develop during the gall attack. The triggering moments of the pathological angioneurotic reaction are suggested in an allergic diathesis, neurovegetative lability and in psychic and physical stress factors, based on the examinations of 50 patients. In order to prevent a development of changes in the biliary duct antihistaminics were used. These had a surprisingly favourable therapeutic effect in heavy as well as weaker gall colics. The findings were compared with the hitherto got knowledge about etiology and therapy of the diseases of the biliary duct. A therapy with antihistaminics is recommended for the prevention of gallstones.