A clinicopathological survey of gallstones in the autopsy population

This prospective study looked at the autopsy prevalence of gallstones and their relationship with symptoms and gallbladder pathology. Fifty consecutive autopsies were selected. The gallbladder was examined macroscopically and microscopically and gallstones were examined, cut and classified. Four females at autopsy had had previous cholecystectomies. Thirty three percent of patients had gallstones at post-mortem with a male to female ratio of 1:1.24. Histological features of the gallbladders were: normal 39.1%, cholecystitis 37.0%, hypertrophy 8.7% and fibrosis 15.2%. Increasing age was significantly associated with increasing common bile duct (CBD) circumference. Muscle hypertrophy and fibrosis may represent part of a spectrum of "burnt out" gallbladder disease. Fifteen percent of autopsy patients had calcular cholecystitis but were asymptomatic and the reason for this is unclear.