Pathogenetic interrelations between cholesterolosis and cholesterol gallstone disease.

In order to define the relationship between cholesterolosis (COL) and cholesterol gallstone disease (CGD), risk factors were comparatively investigated in a great number of patients. Sex, age and metabolic risk factors were the same for both diseases, but gallbladder anomalies and neuroendocrine disturbances were more often associated with COL. The lipid composition of the gallbladder bile was determined in patients with COL. The bile acid decrease and the increase of cholesterol molar concentration (moles %) were found, similar to those known in CGD. The similarity of risk factors and of bile lithogenicity, as well as the frequent association of COL and CGD suggest a pathogenic relationship of both diseases. Local morphological changes in conditions of high biliary cholesterol levels may be responsible for the intraparietal precipitation of cholesterol in COL. Thus, COL seem to be a peculiar variant of CGD and its classification into the heterogeneous group of cholecystoses is at present questionable.