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The predictors of cholelithiasis in female patients with metabolic syndrome

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Cojocaru D.-C., Mitu F., Dascălu C., Manole A., Dima-Cozma C.
Open Medicine
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2014
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vol. 9
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issue 1
108-114
EN
Cholesterol gallstone disease is often associated with the metabolic syndrome. Female gender is an unmodifiable risk factor for cholelithiasis and, in its turn, the metabolic syndrome features a sexual dimorphism which warns that a global approach might overlook important discrimination. We carried out a retrospective analytical case-control study in order to perform a comparative analysis between two groups of female patients with metabolic syndrome and gallstones (n=60) or without gallstones (n=65). All the patients were investigated by abdominal ultrasound and met at least three criteria for the diagnosis of metabolic syndrome. Cases and controls were compared regarding anthropometric measurements, a complex lipid profile, and liver function tests. The risks associated with the likelihood of gallstones were estimated by means of cross-tabulation. In order to rank the significant variables we developed a binary logistic regression model which identified lean body weight ≤ 46.44 kg (OR 0.165; 95% CI 0.045–0.611; P = 0.007), total cholesterol ≥ 4.9 mmol/L (OR 15.948; 95% CI 2.700–94.205; P = 0.002), and direct bilirubin > 5.1 µmol/L (OR 0.056; 95% CI 0.013–0.235; P < 0.001), as variables with significant probability of association with the risk of gallstones in women with metabolic syndrome.
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Giant common bile duct stone

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Han H., Lee J., Song T.
Open Medicine
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2012
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vol. 7
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issue 1
59-62
EN
Bile duct stones, which obstruct the common bile duct, potentially result in complications, such as acute cholangitis and pancreatitis. We present a case involving a patient with normal liver function tests from whom we removed a giant common bile duct stone measuring 7.5 centimeters × 4.0 centimeters × 4.0 centimeters. Postoperatively recurrent common bile duct stones were observed and removed with an endoscopic maneuver in the three-year follow-up period. Recurrent bile duct stones are frequently reported in the case of large size of stones or multiple stones. Surgical treatment may then be considered as a first-line treatment in cases of recurrent common bile duct stones. When an endoscopic or surgical approach is used for the treatment of giant common bile duct stones, careful observation is of the utmost importance and treatment innovations may be necessary.
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