MORPHOFUNCTIONAL CHANGES OF THE GALLBLADDER WALL IN PATIENTS WITH CHRONIC CALCULOUS CHOLECYSTITIS WITH CONCOMITANT DIABETES

According to current international research epithelium of the gallbladder wall participates in the formation of bile components. Gall bladder diseases are accompanied by certain structural changes in its wall. To study the pathological features of the gallbladder wall in patients with chronic calculous cholecystitis with concomitant diabetes, the morphological study of the gallbladder in 44 patients with chronic calculous cholecystitis (group I) and 45 patients with chronic calculous cholecystitis with concomitant diabetes mellitus type II (group II) was conducted. Those 89 gallbladderes were removed in the planned laparoscopic cholecystectomy in patients who had chronic calculous cholecystitis as admission diagnosis. For histopathological study the gallbladder wall fragments were taken from the bottom, body and neck. In all cases macroscopic and histopathological study of surgical specimens (gall bladder) was performed. Protocol of macroscopic study provided a description of exterior body, its size and content. Gallbladders were fixed in 10% formalin solution neutral (Ph-7,0). The fixing time was 24 hours. The resulting sections of gallbladder walls stained with hematoxylin and eosin, by Masson (detection of collagen fibers), with altsianov blue by Stidmen (research nonsulfated glycosaminoglycans) and using the PAS-reaction (identification of sulfated glycosaminoglycans).We have found that in patients with concomitant diabetes and chronic calculous cholecystitis significantly more frequently (in 33.3% of patients) compared to patients with chronic calculous cholecystitis (at 13.6%), total defeat manifested entire body. In the study of patients' gallbladder of the second group, there were found signs of inflammation expressed sclerosis, infiltration of the mucosa by ksantome cells, reducing the activity of secretory epithelium and the tendency to decrease in patients in this group of gallbladder size by sclerosis. For patients of the group I characteristic was an increase in wall thickness of gallbladder by mucosal hyperplasia and hypertrophy of muscle membranes. In group II patients often had multiple concretions, compared with the data of the patients of group I.