Number and size of stones in patients with asymptomatic and symptomatic gallstones and gallbladder carcinoma: A prospective study of 592 cases

The development of gallbladder carcinoma has been correlated with the prese nce of a single large gallstone in two retrospective studies. The objective of the present study was to determine the number and size of gallstones in patients with gallbladder carcinoma compared to asymptomatic and symptomat ic Female patients with gallstones. The following three groups of patients were included in this prospective trial: (A) 78 asymptomatic patients with gallstones; (B) 365 symptomatic patients with gallstones; and (C) 149 patie nts with gallbladder carcinoma. At the end of the operation, the resected g allbladder was opened and the number of stones counted. The maximum size of the stones was determined using calipers. Patients with gallbladder carcin oma were significantly older than patients in the other two groups (P < 0.0 01). In the group with asymptomatic gallstones, there were significantly mo re patients with one single stone, whereas in the group with gallbladder ca rcinoma there were significantly more patients with multiple stones (more t han 11; P < 0.01). Patients with gallbladder carcinoma had significantly la rger stones, regardless of the number of stones present (P < 0.001). We pos tulate that the increase in the number and size of the stones among patient s with gallbladder carcinoma could simply be an effect of aging or it could be a reflection of the long-term presence of stones in the gallbladder rat her than some particular chemical or physical influence.