Pathology of the gallbladder in gallstone pancreatitis.

Although cholecystectomy is routinely performed as a part of treatment for gallstone pancreatitis, detailed histopathologic features of the gallbladder have not been described. In this study, the pathologic findings of 53 gallbladders from patients with clinical and laboratory evidence of gallstone pancreatitis are described. The presence of intraepithelial neutrophilic aggregates, a histologic finding associated with common bile duct obstruction, was identified in 32 (60.4%) cholecystectomy specimens and was the most common pathologic findings. Changes of acute cholecystitis and chronic cholecystitis were found in 15 (28.3%) and 6 (11.3%) gallbladders, respectively. Fat necrosis, which is characteristically associated with acute pancreatitis, was the most specific histologic change, but it was seen in the adventitia of only four gallbladders. The similarities of pathologic findings in gallstone pancreatitis and common bile duct obstruction emphasize the role of choledocholithiasis in the pathogenesis of pancreatitis associated with cholelithiasis.