Rolul disfuncţiei motorii a colecistului şi infecţiei în evoluţia colelitiazei: aspecte etiopatogenetice

Abstract

Background: Gallstones represent a common and costly health problem and calculous cholecystitis is the most prevalent gastroenterological disease which requires a surgical treatment. The changing epidemiology of gallstone disease is reflected by a marked shift in its composition and necessitates the definition of target populations for future non-surgical and surgical therapies. The pathogenesis of gallstone disease is suggested to be multifactorial and many risk factors are not modifiable such as ethnic background, increasing age, female gender and family history or genetics. Classification of gallbladder stones and analysis of the clinical characteristics of each type of stone provide a theoretical basis for the study of the formation mecanism of different types of gallblader stones. By virtue of their active role in the enterohepatic circulation of bile salts, impaired gallbladder empting and infection transit not only contribute to the „lithogenic” state, but also perpetuate it. Conclusions: It is revalued the role of infection in etiopathogenesis of cholestasis through the current concepts of lithogenesis. It is concluded that any disturbance of the activity of the gallbladder may not be reflected in terms of etiopathogenetic on the hepato-bilio-pancreatic area and biliary cholelithiasis is not an exception in this regard.