CHARACTERISTICS OF SYMPTOMATIC GALLBLADDER-DISEASE IN PATIENTS WITH EITHER SOLITARY OR MULTIPLE CHOLESTEROL GALLSTONES

Recent studies have indicated that solitary or multiple gallstones may differ with respect to the conditions favoring their formation, such as nucleation time. We examined the clinical, histological and laborat ory characteristics of symptomatic gallstone disease in a series of 12 5 consecutive patients with either solitary (n = 33) or multiple (n = 92) cholesterol gallstones undergoing cholecystectomy. The nature of b iliary pain was found to differ in the two groups. Histological diagno ses of acute cholecystitis and gallbladder cancer was more frequent in the patients with multiple stones, and cholesterolosis in those with solitary stones. Furthermore, the stone cholesterol content was higher in the solitary stone group than in the multiple stone group. Morbid complications such as cholangitis and pancreatitis were rare and occur red only in the multiple stone group. The results support the view tha t gallbladder disease presents histological evidence of biliary compli cations more often in patients with multiple cholesterol stones than i n those with solitary stones.