Pathology

The pathophysiology of chronic cholecystitis is poorly understood.

• it is thought to be due to recurrent mucosal trauma caused by repeated episodes of low grade gallbladder obstruction
• there is no relationship between the number of stones or their overall volume and the degree of gallbladder wall inflammation
  • stones were not associated with 12-13% of patients with chronic cholecystitis (1)

The role of bacterial infection of the bile in the disease process is not significant since less than one third of bile cultures contain E coli or enterococci.

Reference:

• (1) Elwood DR. Cholecystitis. Surg Clin North Am. 2008;88(6):1241-52